MEDICARE: ASPIREWELL, LLC

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1700347598
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIREWELL, LLC

Provider Business Mailing Address
First Line	:	1615 JACKSON ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-2029
Country	:	US
Telephone Number	:	318-512-2857
Fax Number	:	318-388-4961

Provider Business Practice Location Address
First Line	:	1615 JACKSON ST
Second Line	:
City	:	MONROE
State	:	LA
Zip	:	71202-2029
Country	:	US
Telephone Number	:	318-512-2857
Fax Number	:	318-388-4961

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	JOSEPH N NWUFOH
Credential	:
Telephone Number	:	318-512-2857

Provider Enumeration Date	:	03/26/2019
Last Update Date	:	03/26/2019

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Directions to “ASPIREWELL, LLC ” Practice Location

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