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General NPI Number Information
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NPI Number | 1992905236
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Entity Type | Organization
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Legal Business Name | ASPEN GLEN INC.
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 04/05/2022
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Provider Practice Location Address
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Address Line | 448 BOOKCLIFF DR
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2039
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Country | US
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Telephone | 970-254-8403
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Fax |
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Provider Business Mailing Address
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Address Line | 448 BOOKCLIFF DR
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City | GRAND JUNCTION
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State | CO
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Zip | 81501-2039
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Country | US
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Telephone | 970-254-8403
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Fax |
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Authorized Official
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Title or Position | VP
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Name | LENARD MACLEOD
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Credential |
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Telephone | 970-210-6642
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | AL-0498
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | AL-0498
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License Number State | CO
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