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General NPI Number Information
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NPI Number | 1255260477
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Entity Type | Organization
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Legal Business Name | ASPEN GLEN OPCO LLC
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Dates
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Enumeration Date | 05/14/2026
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Last Update Date | 05/14/2026
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Provider Practice Location Address
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Address Line | 500 SELFRIDGE ST
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City | EAST LIVERPOOL
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State | OH
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Zip | 43920-1978
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Country | US
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Telephone | 330-385-5001
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Fax |
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Provider Business Mailing Address
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Address Line | 5308 13TH AVE STE 398
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City | BROOKLYN
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State | NY
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Zip | 11219-5198
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Country | US
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Telephone | 330-327-7349
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Fax |
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Authorized Official
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Title or Position | VICE PRESIDENT OF LEGAL AFFIARS
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Name | GRACIE BRENDA COEY
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Credential | JD
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Telephone | 330-327-7349
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number |
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License Number State |
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