Provider Demographics
NPI:1932114816
Name:ASPIRA WELLNESS & EDUCATION CENTER INC.
Entity Type:Organization
Organization Name:ASPIRA WELLNESS & EDUCATION CENTER INC.
Other - Org Name:FAMILY SERVICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:WESTON
Authorized Official - Middle Name:
Authorized Official - Last Name:LANGE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-669-2583
Mailing Address - Street 1:5500 E ATHERTON ST
Mailing Address - Street 2:SUITE 316
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4016
Mailing Address - Country:US
Mailing Address - Phone:562-493-3201
Mailing Address - Fax:562-493-3753
Practice Address - Street 1:5500 E ATHERTON ST
Practice Address - Street 2:SUITE 416
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4016
Practice Address - Country:US
Practice Address - Phone:562-493-1496
Practice Address - Fax:562-493-2092
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRA WELLNESS & EDUCATION CENTER INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-07-30
Last Update Date:2010-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW20542Medicare PIN