=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043066079
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASPIRE BEHAVIORAL CARE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/29/2024
-----------------------------------------------------
Last Update Date | 05/02/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 5015 EAGLE ROCK BLVD STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90041-2087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-471-2200
-----------------------------------------------------
Fax | 213-946-5100
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5015 EAGLE ROCK BLVD STE 200
-----------------------------------------------------
City | LOS ANGELES
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 90041-2087
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 213-471-2200
-----------------------------------------------------
Fax | 213-946-5100
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/ CEO
-----------------------------------------------------
Name | CRESILYN JAVIER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 626-497-6500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101Y00000X
-----------------------------------------------------
Taxonomy Name | Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103K00000X
-----------------------------------------------------
Taxonomy Name | Behavior Analyst
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------