MEDICARE: ASPEN DAY TREATMENT, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center		MD

General Provider Information

NPI Number	:	1023366796
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPEN DAY TREATMENT, LLC

Provider Business Mailing Address
First Line	:	1634 SULPHUR SPRING RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-2539
Country	:	US
Telephone Number	:	410-242-0920
Fax Number	:	410-242-0924

Provider Business Practice Location Address
First Line	:	1634 SULPHUR SPRING RD
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21227-2539
Country	:	US
Telephone Number	:	410-242-0920
Fax Number	:	410-242-0924

Authorized Official
Title or Position	:	CEO
Name	:	DR. JEFFREY LAFFERMAN
Credential	:	MD
Telephone Number	:	410-242-0920

Provider Enumeration Date	:	08/28/2012
Last Update Date	:	09/16/2022

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