MEDICARE: ASPIRE LIVING & LEARNING

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	315P00000X	Intellectual Disabilities Intermediate Care Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	62059	OTHER	CT	EDS IDENTIFIER

General Provider Information

NPI Number	:	1730235599
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPIRE LIVING & LEARNING

Provider Business Mailing Address
First Line	:	1764 LITCHFIELD TPKE
Second Line	:
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-2353
Country	:	US
Telephone Number	:	203-389-6956
Fax Number	:	203-389-7094

Provider Business Practice Location Address
First Line	:	490 AMITY RD
Second Line	:
City	:	WOODBRIDGE
State	:	CT
Zip	:	06525-1604
Country	:	US
Telephone Number	:	203-397-0600
Fax Number	:	203-389-1764

Authorized Official
Title or Position	:	PRACTICE MANAGEMENT COORDINATOR
Name	:	REBECCA KHALIL
Credential	:
Telephone Number	:	978-732-3982

Provider Enumeration Date	:	01/26/2007
Last Update Date	:	10/06/2020

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Directions to “ASPIRE LIVING & LEARNING ” Practice Location

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