Provider Demographics
NPI:1114389517
Name:ASPEN MINISTRIES SYRINGA WELLNESS
Entity Type:Organization
Organization Name:ASPEN MINISTRIES SYRINGA WELLNESS
Other - Org Name:SYRINGA WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/OVERSEER
Authorized Official - Prefix:
Authorized Official - First Name:ASPEN
Authorized Official - Middle Name:
Authorized Official - Last Name:MORROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-870-9238
Mailing Address - Street 1:1609 S KIMBALL AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:ID
Mailing Address - Zip Code:83605-5196
Mailing Address - Country:US
Mailing Address - Phone:208-899-8101
Mailing Address - Fax:208-899-8096
Practice Address - Street 1:1609 S KIMBALL AVE STE 200
Practice Address - Street 2:
Practice Address - City:CALDWELL
Practice Address - State:ID
Practice Address - Zip Code:83605-5196
Practice Address - Country:US
Practice Address - Phone:208-899-8101
Practice Address - Fax:208-899-8096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-24
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health