Provider Demographics
NPI:1326853656
Name:SUPPORTING INDEPENDENCE FOR YOUR ASPIRATION LLC
Entity type:Organization
Organization Name:SUPPORTING INDEPENDENCE FOR YOUR ASPIRATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SADICHCHHA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:603-799-7111
Mailing Address - Street 1:190 MORNING GLORY DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-5945
Mailing Address - Country:US
Mailing Address - Phone:603-799-7111
Mailing Address - Fax:
Practice Address - Street 1:190 MORNING GLORY DR
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-5945
Practice Address - Country:US
Practice Address - Phone:603-799-7111
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities