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Organization
ASPIRE HAVEN GROUP HOMES
Active
Organization
ASPIRE HAVEN GROUP HOMES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TANISHA OKONJI M.ED. (BCBA/ CFO)
(770) 905-2521
Entity
Organization
Contact information
Practice address
12708 SAN JOSE BLVD STE 1A, JACKSONVILLE, FL 32223-2600
(770) 318-2828
(888) 846-6014
Mailing address
PO BOX 683, LOGANVILLE, GA 30052-0018
(770) 318-2828
(888) 846-6014
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
—
NULL
103K00000X
Behavior Analyst
—
—
251S00000X
Community/Behavioral Health Agency
—
NULL
3104A0630X
Assisted Living Facility (Behavioral Disturbances)
—
NULL
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
NULL
372600000X
Adult Companion
—
NULL
Other
Enumeration date
08/07/2024
Last updated
08/07/2024
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