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General NPI Number Information
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NPI Number | 1699043984
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Entity Type | Organization
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Legal Business Name | ASPEN ACADEMY
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Dates
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Enumeration Date | 12/01/2011
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Last Update Date | 10/30/2012
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Provider Practice Location Address
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Address Line | 15033 HIGHWAY 13 S SUITE 2000
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City | PRIOR LAKE
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State | MN
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Zip | 55372-2144
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Country | US
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Telephone | 952-226-5940
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Fax | 952-226-5949
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Provider Business Mailing Address
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Address Line | 15033 HIGHWAY 13 S SUITE 2000
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City | PRIOR LAKE
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State | MN
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Zip | 55372-2144
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Country | US
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Telephone | 952-226-5940
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Fax | 952-226-5949
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Authorized Official
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Title or Position | DIRECTOR
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Name | MRS. CYNTHIA SHERAR
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Credential |
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Telephone | 952-226-5940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251300000X
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Taxonomy Name | Local Education Agency (LEA)
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License Number | 4184
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License Number State | MN
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