Provider Demographics
NPI:1689215196
Name:ASPIRE BEHAVIOR SOLUTIONS, LLC
Entity Type:Organization
Organization Name:ASPIRE BEHAVIOR SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:LEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA, LBA
Authorized Official - Phone:916-367-9913
Mailing Address - Street 1:2170 CHATEAU CT
Mailing Address - Street 2:
Mailing Address - City:NORTH POLE
Mailing Address - State:AK
Mailing Address - Zip Code:99705-6583
Mailing Address - Country:US
Mailing Address - Phone:916-367-9913
Mailing Address - Fax:
Practice Address - Street 1:2170 CHATEAU CT
Practice Address - Street 2:
Practice Address - City:NORTH POLE
Practice Address - State:AK
Practice Address - Zip Code:99705-6583
Practice Address - Country:US
Practice Address - Phone:916-367-9913
Practice Address - Fax:907-312-2399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-06
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty