Healthcare Provider Details

I. General information

NPI: 1750991923
Provider Name (Legal Business Name): ASPEN BEHAVIORAL HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/03/2020
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 OSCEOLA DRIVE SUITE 200,300,108
WEST PALM BEACH FL
33409-5075
US

IV. Provider business mailing address

900 OSCEOLA DR STE 108
WEST PALM BEACH FL
33409-5000
US

V. Phone/Fax

Practice location:
  • Phone: 833-737-0963
  • Fax: 561-532-0050
Mailing address:
  • Phone: 833-772-1295
  • Fax: 561-532-0050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number State

VIII. Authorized Official

Name: BIANCA S GERENA
Title or Position: CREDENTIALING AND UR
Credential:
Phone: 561-502-4720