MEDICARE: ASPENWOOD REHABILITATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251K00000X	Public Health or Welfare Agency

General Provider Information

NPI Number	:	1215742747
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASPENWOOD REHABILITATION

Provider Business Mailing Address
First Line	:	598 ADDISON AVE W
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-5039
Country	:	US
Telephone Number	:	208-421-3132
Fax Number	:

Provider Business Practice Location Address
First Line	:	598 ADDISON AVE W
Second Line	:
City	:	TWIN FALLS
State	:	ID
Zip	:	83301-5039
Country	:	US
Telephone Number	:	208-421-3132
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	ROBIN MOORE
Credential	:	BSW, QIDP, BI
Telephone Number	:	208-421-3132

Provider Enumeration Date	:	02/11/2025
Last Update Date	:	02/11/2025

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Directions to “ASPENWOOD REHABILITATION ” Practice Location

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