| Inspire Services, Llc | |
|
32298 State Highway 13 Montgomery MN 56069-4348 | |
| (507) 364-5312 | |
| (507) 364-5908 |
| Full Name | Inspire Services, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 32298 State Highway 13, Montgomery, Minnesota |
| Authorized Official Name and Position | Jonathan Louis Beulke (OWNER/CFO) |
| Authorized Official Contact | 6122408813 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Inspire Services, Llc 32298 State Highway 13 Montgomery MN 56069-4348 Ph: (507) 364-5312 | Inspire Services, Llc 32298 State Highway 13 Montgomery MN 56069-4348 Ph: (507) 364-5312 |
| NPI Number | 1134691975 |
|---|---|
| Provider Enumeration Date | 12/18/2018 |
| Last Update Date | 08/02/2022 |
| Certification Date | 08/02/2022 |
| Medicare PECOS PAC ID | 8729493127 |
|---|---|
| Medicare Enrollment ID | O20210217001385 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134691975 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Tyler Maxwell Dority |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1104394212 PECOS PAC ID: 3476968884 Enrollment ID: I20210217001836 |
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