Provider Demographics
NPI:1528308418
Name:ASPIRE REHAB GROUP
Entity type:Organization
Organization Name:ASPIRE REHAB GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:HAROLD
Authorized Official - Last Name:MCEWEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-757-6517
Mailing Address - Street 1:5908 ALLEN RD SE
Mailing Address - Street 2:
Mailing Address - City:MC CALL CREEK
Mailing Address - State:MS
Mailing Address - Zip Code:39647-5321
Mailing Address - Country:US
Mailing Address - Phone:601-757-6517
Mailing Address - Fax:
Practice Address - Street 1:5908 ALLEN RD SE
Practice Address - Street 2:
Practice Address - City:MC CALL CREEK
Practice Address - State:MS
Practice Address - Zip Code:39647-5321
Practice Address - Country:US
Practice Address - Phone:601-757-6517
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-28
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSOT2040261QR0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation