MEDICARE: ASPIRE BEHAVIORAL HEALTH INC.

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	225400000X	Rehabilitation Practitioner

General Provider Information

NPI Number	:	1457795551
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE BEHAVIORAL HEALTH INC.

Provider Business Mailing Address
First Line	:	2001 S JONES BLVD
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3182
Country	:	US
Telephone Number	:	702-556-1511
Fax Number	:

Provider Business Practice Location Address
First Line	:	2001 S JONES BLVD
Second Line	:	SUITE E
City	:	LAS VEGAS
State	:	NV
Zip	:	89146-3182
Country	:	US
Telephone Number	:	702-556-1511
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR
Name	:	TANITSHA BRIDGERS
Credential	:
Telephone Number	:	702-556-1511

Provider Enumeration Date	:	04/19/2013
Last Update Date	:	04/19/2013

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