Provider Demographics
NPI: | 1083447932 |
---|---|
Name: | INSTITUTE FOR ASPIRE HUMAN DYNAMIC COMMUNITY HEALTHCARE SERVICE |
Entity type: | Organization |
Organization Name: | INSTITUTE FOR ASPIRE HUMAN DYNAMIC COMMUNITY HEALTHCARE SERVICE |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | SHARON |
Authorized Official - Middle Name: | A |
Authorized Official - Last Name: | PEART |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PAS, RNS |
Authorized Official - Phone: | 866-926-0035 |
Mailing Address - Street 1: | 3296 HIGHPOINT CT |
Mailing Address - Street 2: | |
Mailing Address - City: | SNELLVILLE |
Mailing Address - State: | GA |
Mailing Address - Zip Code: | 30078-7401 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 478-988-0937 |
Mailing Address - Fax: | 585-502-1157 |
Practice Address - Street 1: | 400 W CAPITOL AVE |
Practice Address - Street 2: | |
Practice Address - City: | LITTLE ROCK |
Practice Address - State: | AR |
Practice Address - Zip Code: | 72201-3436 |
Practice Address - Country: | US |
Practice Address - Phone: | 478-988-0937 |
Practice Address - Fax: | 585-502-1157 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2024-08-24 |
Last Update Date: | 2024-08-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 251E00000X | Agencies | Home Health | Group - Multi-Specialty | |
No | 163WH0200X | Nursing Service Providers | Registered Nurse | Home Health | Group - Multi-Specialty |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health | Group - Multi-Specialty |
No | 2279H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Registered | Home Health | Group - Multi-Specialty |
No | 251F00000X | Agencies | Home Infusion | ||
No | 251J00000X | Agencies | Nursing Care | ||
No | 332B00000X | Suppliers | Durable Medical Equipment & Medical Supplies | ||
No | 332BC3200X | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | |
No | 332BD1200X | Suppliers | Durable Medical Equipment & Medical Supplies | Dialysis Equipment & Supplies | |
No | 332BN1400X | Suppliers | Durable Medical Equipment & Medical Supplies | Nursing Facility Supplies | |
No | 332BP3500X | Suppliers | Durable Medical Equipment & Medical Supplies | Parenteral & Enteral Nutrition | |
No | 332BX2000X | Suppliers | Durable Medical Equipment & Medical Supplies | Oxygen Equipment & Supplies | |
No | 343900000X | Transportation Services | Non-emergency Medical Transport (VAN) | ||
No | 364SH0200X | Physician Assistants & Advanced Practice Nursing Providers | Clinical Nurse Specialist | Home Health | Group - Multi-Specialty |
No | 374U00000X | Nursing Service Related Providers | Home Health Aide | Group - Multi-Specialty |