Healthcare Provider Details

I. General information

NPI: 1073166278
Provider Name (Legal Business Name): ASCEND TELEMEDICINE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2019
Last Update Date: 11/27/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

312 N ALMA SCHOOL RD STE 11
CHANDLER AZ
85224-4354
US

IV. Provider business mailing address

312 N ALMA SCHOOL RD STE 11
CHANDLER AZ
85224-4354
US

V. Phone/Fax

Practice location:
  • Phone: 814-853-3489
  • Fax:
Mailing address:
  • Phone: 814-853-3489
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number
License Number State

VIII. Authorized Official

Name: JOSHUA LESLIE
Title or Position: COO, CO-FOUNDER
Credential: PA-C
Phone: 814-853-3489