Healthcare Provider Details
I. General information
NPI: 1073447504
Provider Name (Legal Business Name): ASPIRE PEERS AZ LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10 LEMBERG CT APT 6
MONROE NY
10950-6582
US
IV. Provider business mailing address
10 LEMBERG CT APT 6
MONROE NY
10950-6582
US
V. Phone/Fax
- Phone: 845-219-5300
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOEL
GANDL
Title or Position: OWNER
Credential:
Phone: 845-219-5300