Healthcare Provider Details
I. General information
NPI: 1588358220
Provider Name (Legal Business Name): ASLB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2023
Last Update Date: 06/06/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3747 ATLANTIC AVE
LONG BEACH CA
90807-3428
US
IV. Provider business mailing address
28202 CABOT RD STE 412
LAGUNA NIGUEL CA
92677-1271
US
V. Phone/Fax
- Phone: 562-426-6123
- Fax:
- Phone: 949-347-7100
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 314000000X |
| Taxonomy | Skilled Nursing Facility |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JARED
KIRKWOOD
Title or Position: GENERAL COUNSEL
Credential:
Phone: 949-347-7100