Provider Demographics
NPI:1821607680
Name:ASPEN MEADOWS ASSISTED LIVING, LLC
Entity Type:Organization
Organization Name:ASPEN MEADOWS ASSISTED LIVING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:BRENDON
Authorized Official - Middle Name:GERALD
Authorized Official - Last Name:RAVENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:970-201-6678
Mailing Address - Street 1:476 GUNNISON WAY
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5849
Mailing Address - Country:US
Mailing Address - Phone:970-433-7385
Mailing Address - Fax:970-433-7475
Practice Address - Street 1:476 GUNNISON WAY
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5849
Practice Address - Country:US
Practice Address - Phone:970-433-7385
Practice Address - Fax:970-433-7475
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-28
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness