Provider Demographics
NPI:1700380987
Name:ASPIRE INTELLECTUAL AND DEVELOPMENTAL DISABILITY SERVICES LLC
Entity Type:Organization
Organization Name:ASPIRE INTELLECTUAL AND DEVELOPMENTAL DISABILITY SERVICES LLC
Other - Org Name:ASPIRE IDDS,LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MILLICENT
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-687-1211
Mailing Address - Street 1:380 PARADISE CIR APT E6
Mailing Address - Street 2:
Mailing Address - City:WOODLAND PARK
Mailing Address - State:CO
Mailing Address - Zip Code:80863-9009
Mailing Address - Country:US
Mailing Address - Phone:719-687-1211
Mailing Address - Fax:
Practice Address - Street 1:380 PARADISE CIR APT E6
Practice Address - Street 2:
Practice Address - City:WOODLAND PARK
Practice Address - State:CO
Practice Address - Zip Code:80863
Practice Address - Country:US
Practice Address - Phone:719-687-1211
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-21
Last Update Date:2018-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)