Provider Demographics
NPI:1184058117
Name:ASPEN, INC
Entity type:Organization
Organization Name:ASPEN, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROGER
Authorized Official - Middle Name:E
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:620-272-6186
Mailing Address - Street 1:1850 T BONE DR
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-9019
Mailing Address - Country:US
Mailing Address - Phone:620-272-6186
Mailing Address - Fax:620-275-0735
Practice Address - Street 1:1850 T BONE DR
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-9019
Practice Address - Country:US
Practice Address - Phone:620-272-6186
Practice Address - Fax:620-275-0735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-27
Last Update Date:2013-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSAAA251B00000X, 253Z00000X, 251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care