Healthcare Provider Details

I. General information

NPI: 1407313018
Provider Name (Legal Business Name): ASANA PALLIATIVE CLEVELAND LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2019
Last Update Date: 04/23/2024
Certification Date: 04/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 BRIGGS DR UNIT 3
ONTARIO OH
44906-3805
US

IV. Provider business mailing address

3854 AMERICAN WAY STE A
BATON ROUGE LA
70816-4897
US

V. Phone/Fax

Practice location:
  • Phone: 877-202-2869
  • Fax:
Mailing address:
  • Phone: 225-292-2031
  • Fax: 225-295-9678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: SCOTT GERALD GINN
Title or Position: CFO
Credential:
Phone: 225-292-2031