Organization
ASPIRATIONS 2B
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. RENEE BORDAIN (CEO/DIRECTOR)
(678) 361-0644
Entity
Organization
Contact information
Practice address
8268 CREEKRIDGE CIR, RIVERDALE, GA 30296-1243
(678) 361-0644
(770) 460-0459
Mailing address
8268 CREEKRIDGE CIR, RIVERDALE, GA 30296-1243
(678) 361-0644
(770) 460-0459
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
634367146A
—
GA
Enumeration date
12/28/2009
Last updated
11/19/2010
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