Healthcare Provider Details

I. General information

NPI: 1124016050
Provider Name (Legal Business Name): ASPIRE INDIANA INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

697 PRO MED LN
CARMEL IN
46032-5323
US

IV. Provider business mailing address

697 PRO MED LN
CARMEL IN
46032-5323
US

V. Phone/Fax

Practice location:
  • Phone: 317-574-1254
  • Fax: 317-674-0060
Mailing address:
  • Phone: 317-574-1254
  • Fax: 317-674-0060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY D CROCKETT
Title or Position: CFO
Credential:
Phone: 317-587-0505