=====================================================
General NPI Number Information
=====================================================
NPI Number | 1942573993
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ASPIRE HOME HEALTH CARE SERVICES LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/21/2012
-----------------------------------------------------
Last Update Date | 11/28/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 306 REICHELDERFER RD
-----------------------------------------------------
City | CRIDERSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45806-2252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-738-1176
-----------------------------------------------------
Fax | 419-738-1173
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 306 REICHELDERFER RD
-----------------------------------------------------
City | CRIDERSVILLE
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45806-2252
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-738-1176
-----------------------------------------------------
Fax | 419-738-1173
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | ASHLEY BLACKBURN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 419-738-1176
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251E00000X
-----------------------------------------------------
Taxonomy Name | Home Health Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------