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General NPI Number Information
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NPI Number | 1538505516
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Entity Type | Organization
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Legal Business Name | ASPIRE COUNSELING CENTER LLC
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Dates
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Enumeration Date | 05/16/2013
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Last Update Date | 05/16/2013
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Provider Practice Location Address
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Address Line | 3804 E 29TH ST
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City | DES MOINES
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State | IA
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Zip | 50317-4232
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Country | US
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Telephone | 515-557-0415
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 57441
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City | DES MOINES
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State | IA
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Zip | 50317-0008
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KENNETH D CAMERON
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Credential |
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Telephone | 515-557-0415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 001356
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License Number State | IA
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