Healthcare Provider Details

I. General information

NPI: 1124944509
Provider Name (Legal Business Name): ASPIRE COMMUNITY SUPPORT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2323 GRAND AVE
DES MOINES IA
50312-5307
US

IV. Provider business mailing address

12079 EVERGREEN ST NW
COON RAPIDS MN
55448-2433
US

V. Phone/Fax

Practice location:
  • Phone: 612-517-4501
  • Fax: 612-487-2452
Mailing address:
  • Phone: 612-517-4501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. ABDIHALIM SHARIF MOHAMED
Title or Position: CO OWNER
Credential:
Phone: 612-487-2452