Healthcare Provider Details

I. General information

NPI: 1255260477
Provider Name (Legal Business Name): ASPEN GLEN OPCO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 SELFRIDGE ST
EAST LIVERPOOL OH
43920-1978
US

IV. Provider business mailing address

5308 13TH AVE STE 398
BROOKLYN NY
11219-5198
US

V. Phone/Fax

Practice location:
  • Phone: 330-385-5001
  • Fax:
Mailing address:
  • Phone: 330-327-7349
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: GRACIE BRENDA COEY
Title or Position: VICE PRESIDENT OF LEGAL AFFIARS
Credential: JD
Phone: 330-327-7349