Provider Demographics
NPI:1265022677
Name:ASPEN RIDGE RECOVERY
Entity Type:Organization
Organization Name:ASPEN RIDGE RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:SHYANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:CHING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:719-569-5517
Mailing Address - Street 1:10155 W KENTUCKY DR
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80226-7521
Mailing Address - Country:US
Mailing Address - Phone:720-330-3632
Mailing Address - Fax:
Practice Address - Street 1:1223 LAKE PLAZA DR STE C
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-3580
Practice Address - Country:US
Practice Address - Phone:719-627-2107
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPENRIDGE RECOVERY
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-01-20
Last Update Date:2023-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO1774-03OtherOFFICE OF BEHAVIORAL HEALTH