Provider Demographics
NPI:1104586874
Name:ASPIRE NETWORK INC PROFESSIONAL SERVICE CORPORATION ASPIRE NETWORK
Entity type:Organization
Organization Name:ASPIRE NETWORK INC PROFESSIONAL SERVICE CORPORATION ASPIRE NETWORK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:EDWIN
Authorized Official - Middle Name:NYUMAH
Authorized Official - Last Name:SWARAY
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:763-202-4767
Mailing Address - Street 1:5701 KENTUCKY AVE N STE 100
Mailing Address - Street 2:
Mailing Address - City:CRYSTAL
Mailing Address - State:MN
Mailing Address - Zip Code:55428-3370
Mailing Address - Country:US
Mailing Address - Phone:763-202-4767
Mailing Address - Fax:
Practice Address - Street 1:5701 KENTUCKY AVE N STE 100
Practice Address - Street 2:
Practice Address - City:CRYSTAL
Practice Address - State:MN
Practice Address - Zip Code:55428-3370
Practice Address - Country:US
Practice Address - Phone:763-202-4767
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-22
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)