Provider Demographics
NPI:1508686403
Name:INSPIRE GROWTH ABA CORP
Entity type:Organization
Organization Name:INSPIRE GROWTH ABA CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:YOCHEVED
Authorized Official - Middle Name:
Authorized Official - Last Name:WASSERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:845-596-2271
Mailing Address - Street 1:1531 32ND AVE S STE 102
Mailing Address - Street 2:
Mailing Address - City:FARGO
Mailing Address - State:ND
Mailing Address - Zip Code:58103-5911
Mailing Address - Country:US
Mailing Address - Phone:877-734-8787
Mailing Address - Fax:718-568-5271
Practice Address - Street 1:1531 32ND AVE S STE 102
Practice Address - Street 2:
Practice Address - City:FARGO
Practice Address - State:ND
Practice Address - Zip Code:58103-5911
Practice Address - Country:US
Practice Address - Phone:877-734-8787
Practice Address - Fax:718-568-5271
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty