MEDICARE: INSTITUTE FOR ASPIRE HUMAN DYNAMIC COMMUNITY HEALTHCARE SERVICE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251G00000X	Community Based Hospice Care Agency

General Provider Information

NPI Number	:	1144076498
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INSTITUTE FOR ASPIRE HUMAN DYNAMIC COMMUNITY HEALTHCARE SERVICE

Provider Business Mailing Address
First Line	:	3296 HIGHPOINT CT
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-7401
Country	:	US
Telephone Number	:	719-517-6905
Fax Number	:	585-502-1157

Provider Business Practice Location Address
First Line	:	2992 W MAIN ST
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-5764
Country	:	US
Telephone Number	:	866-926-0035
Fax Number	:	585-502-1157

Authorized Official
Title or Position	:	DIRECTOR
Name	:	SHARON A PEART
Credential	:
Telephone Number	:	866-926-0035

Provider Enumeration Date	:	04/27/2024
Last Update Date	:	04/27/2024

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