Provider Demographics
NPI:1073876843
Name:ASPEN TREATMENT SERVICES INC
Entity Type:Organization
Organization Name:ASPEN TREATMENT SERVICES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YUMIL
Authorized Official - Middle Name:
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MED
Authorized Official - Phone:303-926-4188
Mailing Address - Street 1:275 WANEKA PKWY
Mailing Address - Street 2:#10
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-8873
Mailing Address - Country:US
Mailing Address - Phone:303-926-4188
Mailing Address - Fax:303-926-4202
Practice Address - Street 1:275 WANEKA PKWY
Practice Address - Street 2:#10
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-8873
Practice Address - Country:US
Practice Address - Phone:303-926-4188
Practice Address - Fax:303-926-4202
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1646-00251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health