Provider Demographics
NPI:1760506356
Name:ASPIRA BEHAVIORAL HEALTH
Entity Type:Organization
Organization Name:ASPIRA BEHAVIORAL HEALTH
Other - Org Name:ASPIRA BEHAVIORAL HEALTH
Other - Org Type:Other Name
Authorized Official - Title/Position:CASE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:JANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-669-2583
Mailing Address - Street 1:707 NORTH BROADWAY
Mailing Address - Street 2:
Mailing Address - City:TURLOCK
Mailing Address - State:CA
Mailing Address - Zip Code:95380
Mailing Address - Country:US
Mailing Address - Phone:209-669-2583
Mailing Address - Fax:
Practice Address - Street 1:707 N BROADWAY
Practice Address - Street 2:
Practice Address - City:TURLOCK
Practice Address - State:CA
Practice Address - Zip Code:95380-3841
Practice Address - Country:US
Practice Address - Phone:209-669-2583
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management