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General NPI Number Information
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NPI Number | 1265762165
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Entity Type | Organization
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Legal Business Name | ASPIRATIONS 2B
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Dates
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Enumeration Date | 12/28/2009
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Last Update Date | 11/19/2010
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Provider Practice Location Address
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Address Line | 8268 CREEKRIDGE CIR
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City | RIVERDALE
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State | GA
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Zip | 30296-1243
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Country | US
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Telephone | 678-361-0644
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Fax | 770-460-0459
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Provider Business Mailing Address
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Address Line | 8268 CREEKRIDGE CIR
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City | RIVERDALE
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State | GA
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Zip | 30296-1243
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Country | US
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Telephone | 678-361-0644
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Fax | 770-460-0459
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Authorized Official
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Title or Position | CEO/DIRECTOR
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Name | MS. RENEE BORDAIN
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Credential |
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Telephone | 678-361-0644
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | GA
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