Provider Demographics
NPI:1649262411
Name:ASPEN LIVING CENTERS INC
Entity type:Organization
Organization Name:ASPEN LIVING CENTERS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JAY
Authorized Official - Last Name:BUMPASS
Authorized Official - Suffix:
Authorized Official - Credentials:LNHA
Authorized Official - Phone:254-716-3616
Mailing Address - Street 1:1415 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78520-6549
Mailing Address - Country:US
Mailing Address - Phone:956-546-3711
Mailing Address - Fax:956-546-3799
Practice Address - Street 1:1415 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6549
Practice Address - Country:US
Practice Address - Phone:956-546-3711
Practice Address - Fax:956-546-3799
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-08-18
Last Update Date:2008-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320600000XResidential Treatment FacilitiesResidential Treatment Facility, Intellectual and/or Developmental Disabilities