Healthcare Provider Details

I. General information

NPI: 1336906866
Provider Name (Legal Business Name): ASRF, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2024
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FOUNTAINGROVE PKWY
SANTA ROSA CA
95403-5720
US

IV. Provider business mailing address

28202 CABOT RD STE 412
LAGUNA NIGUEL CA
92677-1271
US

V. Phone/Fax

Practice location:
  • Phone: 707-566-8600
  • Fax:
Mailing address:
  • Phone: 949-347-7100
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: JARED KIRKWOOD
Title or Position: GENERAL COUNSEL
Credential:
Phone: 949-347-7100