Provider Demographics
NPI:1922982669
Name:ASPIRE BEHAVIORAL GROUP LLC
Entity type:Organization
Organization Name:ASPIRE BEHAVIORAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KISHAN RAO
Authorized Official - Middle Name:
Authorized Official - Last Name:BAGAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:314-420-8190
Mailing Address - Street 1:1424 ELLICOTT DR
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-0894
Mailing Address - Country:US
Mailing Address - Phone:314-420-8190
Mailing Address - Fax:
Practice Address - Street 1:1424 ELLICOTT DR
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-0894
Practice Address - Country:US
Practice Address - Phone:314-420-8190
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No251S00000XAgenciesCommunity/Behavioral Health