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General NPI Number Information
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NPI Number | 1437854288
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Entity Type | Organization
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Legal Business Name | ASPIRING LIVING SERVICES
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Dates
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Enumeration Date | 04/03/2023
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Last Update Date | 04/03/2023
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Provider Practice Location Address
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Address Line | 115 WESTHAVEN CT
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City | SPARTANBURG
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State | SC
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Zip | 29301-5539
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Country | US
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Telephone | 864-436-2423
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Fax |
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Provider Business Mailing Address
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Address Line | 205 WILLIAMS RD
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City | ROEBUCK
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State | SC
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Zip | 29376-3429
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Country | US
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Telephone | 864-921-9237
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Fax |
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Authorized Official
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Title or Position | COFOUNDER
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Name | LANETRA EBRON
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Credential |
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Telephone | 864-921-9237
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251T00000X
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Taxonomy Name | PACE Provider Organization
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License Number |
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License Number State |
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