1932255718 NPI number — ASPIRE LIVING & LEARNING

Table of content: (NPI 1932255718)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932255718 NPI number — ASPIRE LIVING & LEARNING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASPIRE LIVING & LEARNING
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932255718
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/06/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1764 LITCHFIELD TPKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODBRIDGE
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06525-2353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-389-6956
Provider Business Mailing Address Fax Number:
203-389-7094

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 MAPLE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06512-1136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-468-8822
Provider Business Practice Location Address Fax Number:
203-468-0458
Provider Enumeration Date:
01/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KHALIL
Authorized Official First Name:
REBECCA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRACTICE MANAGEMENT COORDINATOR
Authorized Official Telephone Number:
978-732-3982

Provider Taxonomy Codes

  • Taxonomy code: 315P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 61986 . This is a "EDS IDENTIFIER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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