Aspen Meadows Assisted Living, LLC

Key facts

NPI

1821607680

Entity type

Organization (NPI type 2)

Primary specialty

Assisted Living Facility (Mental Illness) 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

Organization subpart

No

Authorized official

Name

Brendon Gerald Ravens

Title

Administrator

Phone

(970) 201-6678

National Provider Directory

Specialties & licenses

Addresses

Other names

• Angkor Wat Alternative Care Former legal business name

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 28, 2020.

{
    "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"
        }
    ]
}

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All providers in Grand Junction, CO · Assisted Living Facility (Mental Illness) in Colorado