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General NPI Number Information
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NPI Number | 1649778473
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Entity Type | Organization
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Legal Business Name | ASPEN GUARDIAN SERVICES, INC.
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Dates
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Enumeration Date | 01/26/2018
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Last Update Date | 07/21/2021
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Provider Practice Location Address
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Address Line | 107 MAPLE ST E
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City | AMERY
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State | WI
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Zip | 54001-1122
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Country | US
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Telephone | 715-497-2433
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Fax | 715-268-2433
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Provider Business Mailing Address
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Address Line | PO BOX 15
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City | AMERY
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State | WI
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Zip | 54001-0015
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CORPORATE GUARDIAN
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Name | ALLISON BENSON
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Credential | CORPORATE GUARDIAN
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Telephone | 715-497-2433
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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 |
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License Number State |
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