Provider Demographics
NPI:1992941728
Name:ASPIRE MENTAL HEALTH, LLC
Entity type:Organization
Organization Name:ASPIRE MENTAL HEALTH, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:D
Authorized Official - Last Name:JANDL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:612-822-5557
Mailing Address - Street 1:1595 SELBY AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55104-6221
Mailing Address - Country:US
Mailing Address - Phone:612-220-6020
Mailing Address - Fax:
Practice Address - Street 1:1595 SELBY AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55104-6221
Practice Address - Country:US
Practice Address - Phone:612-220-6020
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-29
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Single Specialty