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General NPI Number Information
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NPI Number | 1073876843
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Entity Type | Organization
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Legal Business Name | ASPEN TREATMENT SERVICES INC
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Dates
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Enumeration Date | 06/18/2012
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Last Update Date | 06/18/2012
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Provider Practice Location Address
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Address Line | 275 WANEKA PKWY #10
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City | LAFAYETTE
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State | CO
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Zip | 80026-8873
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Country | US
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Telephone | 303-926-4188
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Fax | 303-926-4202
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Provider Business Mailing Address
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Address Line | 275 WANEKA PKWY #10
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City | LAFAYETTE
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State | CO
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Zip | 80026-8873
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Country | US
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Telephone | 303-926-4188
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Fax | 303-926-4202
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Authorized Official
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Title or Position | OWNER
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Name | YUMIL JIMENEZ
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Credential | M.ED.
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Telephone | 303-926-4188
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | 1646-00
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License Number State | CO
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