Provider Demographics
NPI:1790977478
Name:ASPEN GARDENS LLC
Entity Type:Organization
Organization Name:ASPEN GARDENS LLC
Other - Org Name:ASPEN GARDENS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAHARG
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:406-461-0898
Mailing Address - Street 1:709 SILVERETTE ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-5931
Mailing Address - Country:US
Mailing Address - Phone:406-461-0896
Mailing Address - Fax:
Practice Address - Street 1:16 BUMBLEBEE CT
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-8612
Practice Address - Country:US
Practice Address - Phone:406-457-0092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-15
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT10798310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT11474D9B20Medicaid