Provider Demographics
NPI:1851560809
Name:ASPEN MENTAL HEALTH
Entity Type:Organization
Organization Name:ASPEN MENTAL HEALTH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:TOTH
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:208-342-2950
Mailing Address - Street 1:2316 N COLE RD
Mailing Address - Street 2:SUITE B
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83704-7365
Mailing Address - Country:US
Mailing Address - Phone:208-342-2950
Mailing Address - Fax:
Practice Address - Street 1:2316 N COLE RD
Practice Address - Street 2:SUITE B
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83704-7365
Practice Address - Country:US
Practice Address - Phone:208-342-2950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-25
Last Update Date:2008-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCPC3978251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health