Healthcare Provider Details

I. General information

NPI: 1346021490
Provider Name (Legal Business Name): ASPIRE NEVADA. LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2023
Last Update Date: 10/12/2023
Certification Date: 10/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N RAINBOW BLVD STE 208-24
LAS VEGAS NV
89107-1189
US

IV. Provider business mailing address

5546 CAMINO AL NORTE STE 2-185
NORTH LAS VEGAS NV
89031-0805
US

V. Phone/Fax

Practice location:
  • Phone: 702-354-0017
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103TM1800X
TaxonomyIntellectual & Developmental Disabilities Psychologist
License Number
License Number State

VIII. Authorized Official

Name: MS. KIMBERLY ARSON
Title or Position: MANAGER
Credential:
Phone: 702-354-0017