Provider Demographics
NPI:1811655475
Name:ASPIRE AUTISM CENTER
Entity type:Organization
Organization Name:ASPIRE AUTISM CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/BCBA
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:KASUN
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:740-336-1710
Mailing Address - Street 1:1402 COLEGATE DR
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-1330
Mailing Address - Country:US
Mailing Address - Phone:740-336-1710
Mailing Address - Fax:
Practice Address - Street 1:1402 COLEGATE DR
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:OH
Practice Address - Zip Code:45750-1330
Practice Address - Country:US
Practice Address - Phone:740-336-1710
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPIRE AUTISM CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-12-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center