Provider Demographics
NPI:1063195949
Name:ASPIRE BEHVIORAL HEALTHCARE, LLC
Entity type:Organization
Organization Name:ASPIRE BEHVIORAL HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:BENEDICT
Authorized Official - Middle Name:C
Authorized Official - Last Name:IJOMAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-821-1671
Mailing Address - Street 1:8500 ANNAPOLIS RD STE 101
Mailing Address - Street 2:
Mailing Address - City:NEW CARROLLTON
Mailing Address - State:MD
Mailing Address - Zip Code:20784-3021
Mailing Address - Country:US
Mailing Address - Phone:301-821-1671
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:8500 ANNAPOLIS RD STE 101
Practice Address - Street 2:
Practice Address - City:NEW CARROLLTON
Practice Address - State:MD
Practice Address - Zip Code:20784-3021
Practice Address - Country:US
Practice Address - Phone:301-821-1671
Practice Address - Fax:000-000-0000
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-08
Last Update Date:2024-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty