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General NPI Number Information
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NPI Number | 1063195949
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Entity Type | Organization
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Legal Business Name | ASPIRE BEHVIORAL HEALTHCARE, LLC
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Dates
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Enumeration Date | 08/08/2023
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 8500 ANNAPOLIS RD STE 101
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3021
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Country | US
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Telephone | 301-821-1671
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Fax | --
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Provider Business Mailing Address
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Address Line | 8500 ANNAPOLIS RD STE 101
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City | NEW CARROLLTON
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State | MD
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Zip | 20784-3021
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Country | US
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Telephone | 301-821-1671
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Fax | --
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Authorized Official
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Title or Position | OWNER
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Name | MR. BENEDICT C IJOMAH
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Credential |
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Telephone | 301-821-1671
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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