Organization Active NPI

Aspen Meadows Assisted Living, LLC

  • Assisted Living Facility (Mental Illness)
  • Grand Junction, CO
National Provider Identifier
1821607680
Registry record updated Jul 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Assisted Living Facility (Mental Illness)Taxonomy code 3104A0625X
Legal business name
ASPEN MEADOWS ASSISTED LIVING, LLC
Practice address
476 Gunnison Way
Grand Junction, CO 81504-5849
Phone
(970) 433-7385
Fax
(970) 433-7475
NPI assigned
Jul 28, 2020
Last updated
Jul 28, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Brendon Gerald Ravens
Title
Administrator
Phone
(970) 201-6678

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Assisted Living Facility (Mental Illness) 3104A0625X Primary

Addresses

Primary practice location

476 Gunnison Way
Grand Junction, CO 81504-5849

Mailing address

476 Gunnison Way
Grand Junction, CO 81504-5849
Phone (970) 433-7385

Other names 1

  • Angkor Wat Alternative Care Former legal business name

National Provider Directory

National Provider Directory

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595894400000",
    "number": "1821607680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "476 GUNNISON WAY",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815045849",
            "telephone_number": "970-433-7385",
            "fax_number": "970-433-7475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 GUNNISON WAY",
            "city": "GRAND JUNCTION",
            "state": "CO",
            "postal_code": "815045849",
            "telephone_number": "970-433-7385",
            "fax_number": "970-433-7475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASPEN MEADOWS ASSISTED LIVING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-28",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A",
        "authorized_official_last_name": "RAVENS",
        "authorized_official_first_name": "BRENDON",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "970-201-6678"
    },
    "taxonomies": [
        {
            "code": "3104A0625X",
            "taxonomy_group": "",
            "desc": "Assisted Living Facility, Assisted Living, Mental Illness",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Angkor Wat Alternative Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Grand Junction, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.