Organization Name: | ASPEN CENTER REHABILITATION AND COUNSELING |
NPI Number: | 1760693311 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KIM MARIE SIX (PRESIDENT) |
Mailing Address: | 140 N. 1st E. Driggs |
State: | ID US |
Postal Code: | 83442 |
Phone Number: | 2083543601 |
Fax Number: | 2083543602 |
NPI Enumeration Date: | 05/25/2007 |
NPI Last Update Date: | 07/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QM0801X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Mental Health (Including Community Mental Health Center) |
Taxonomy Definition: |