Provider Demographics
NPI:1891023925
Name:ASPIRE FOR THE PROVISION OF PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SP
Entity Type:Organization
Organization Name:ASPIRE FOR THE PROVISION OF PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:HELEN
Authorized Official - Middle Name:
Authorized Official - Last Name:BLOOMER
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:518-798-7222
Mailing Address - Street 1:178 WARREN ST
Mailing Address - Street 2:
Mailing Address - City:GLENS FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:12801-3721
Mailing Address - Country:US
Mailing Address - Phone:518-798-7222
Mailing Address - Fax:518-798-7223
Practice Address - Street 1:178 WARREN ST
Practice Address - Street 2:
Practice Address - City:GLENS FALLS
Practice Address - State:NY
Practice Address - Zip Code:12801-3721
Practice Address - Country:US
Practice Address - Phone:518-798-7222
Practice Address - Fax:518-798-7223
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-12-01
Last Update Date:2009-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty