MEDICARE: ASPIRE COMMUNITY LIVING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

General Provider Information

NPI Number	:	1740093319
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE COMMUNITY LIVING

Provider Business Mailing Address
First Line	:	807 S POST OAK LN APT 1421
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-2268
Country	:	US
Telephone Number	:	832-819-4423
Fax Number	:

Provider Business Practice Location Address
First Line	:	807 S POST OAK LN APT 1421
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77056-2268
Country	:	US
Telephone Number	:	832-819-4423
Fax Number	:

Authorized Official
Title or Position	:	PROGRAM MANAGER
Name	:	SHELBY SUEANN MCKENZIE
Credential	:	LVN
Telephone Number	:	312-468-1433

Provider Enumeration Date	:	01/28/2025
Last Update Date	:	07/18/2025

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Directions to “ASPIRE COMMUNITY LIVING ” Practice Location

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