Provider Demographics
NPI:1649048455
Name:ASPEN RECOVERY
Entity type:Organization
Organization Name:ASPEN RECOVERY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:KASRIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NOJOWITZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-667-5615
Mailing Address - Street 1:279 OAKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07740-5025
Mailing Address - Country:US
Mailing Address - Phone:646-667-5615
Mailing Address - Fax:
Practice Address - Street 1:279 OAKLEY AVE
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-5025
Practice Address - Country:US
Practice Address - Phone:646-667-5615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility