Provider Demographics
NPI:1124579552
Name:ASPIRE ASSESSMENTS & HEALTH RESOURCES
Entity type:Organization
Organization Name:ASPIRE ASSESSMENTS & HEALTH RESOURCES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE-PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:DOREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:CANADAY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:208-921-1024
Mailing Address - Street 1:4696 W OVERLAND RD STE 128
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83705-2816
Mailing Address - Country:US
Mailing Address - Phone:208-921-1024
Mailing Address - Fax:
Practice Address - Street 1:4696 W OVERLAND RD STE 128
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83705-2816
Practice Address - Country:US
Practice Address - Phone:208-921-1024
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-20
Last Update Date:2016-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ID251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health