Provider Demographics
NPI:1235659624
Name:ASPEN CARE GROUP, LLC
Entity type:Organization
Organization Name:ASPEN CARE GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:CALUNGSUD
Authorized Official - Last Name:ESTEBAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:818-836-4240
Mailing Address - Street 1:3482 ALCUDIA BAY AVE
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89141-3206
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3482 ALCUDIA BAY AVE
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89141-3206
Practice Address - Country:US
Practice Address - Phone:818-836-4240
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-26
Last Update Date:2017-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care