# ASPIRE HAVEN GROUP HOMES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568293017
- **Authorized official:** TANISHA OKONJI M.ED. (BCBA/ CFO)
- **Authorized official phone:** (770) 905-2521

## Contact information

- **Practice address:** 12708 SAN JOSE BLVD STE 1A, JACKSONVILLE, FL 32223-2600
- **Practice address phone:** (770) 318-2828
- **Practice address fax:** (888) 846-6014
- **Mailing address:** PO BOX 683, LOGANVILLE, GA 30052-0018
- **Mailing address phone:** (770) 318-2828
- **Mailing address fax:** (888) 846-6014

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 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 | — | NULL | Yes |
| 372600000X | Adult Companion | — | NULL | — |

## Other

- **Enumeration date:** 08/07/2024
- **Last updated:** 08/07/2024