Provider Demographics
NPI:1093231987
Name:ASPIRE PSYCHIATRIC SERVICES, LLC
Entity Type:Organization
Organization Name:ASPIRE PSYCHIATRIC SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LOIS
Authorized Official - Middle Name:E
Authorized Official - Last Name:WALKER
Authorized Official - Suffix:
Authorized Official - Credentials:APN
Authorized Official - Phone:501-352-5164
Mailing Address - Street 1:625 N 1ST ST STE C
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72076-4138
Mailing Address - Country:US
Mailing Address - Phone:501-985-0292
Mailing Address - Fax:501-985-2070
Practice Address - Street 1:625 N 1ST ST STE C
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72076-4138
Practice Address - Country:US
Practice Address - Phone:501-985-0292
Practice Address - Fax:501-985-2070
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)