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General NPI Number Information
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NPI Number | 1528921921
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Entity Type | Organization
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Legal Business Name | ASPIRE HEALTH ALLIANCE
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Dates
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Enumeration Date | 12/03/2025
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Last Update Date | 12/03/2025
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Provider Practice Location Address
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Address Line | 460 QUINCY AVE
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City | QUINCY
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State | MA
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Zip | 02169-8130
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Country | US
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Telephone | 617-847-1950
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Fax |
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Provider Business Mailing Address
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Address Line | 220 BEDFORD ST BRIDGEWATER H10
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City | BRIDGEWATER
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State | MA
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Zip | 02324-3146
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Country | US
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Telephone | 508-631-7468
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Fax | 508-631-7468
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Authorized Official
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Title or Position | MENTAL HEALTH WORKER
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Name | ISSIAH CHARLES DONAHUE-VIL
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Credential |
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Telephone | 508-631-7468
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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