Healthcare Provider Details

I. General information

NPI: 1134116650
Provider Name (Legal Business Name): ASHLEY ENTERPRISES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 04/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5291 ASHLEY CIR
YOUNGSTOWN OH
44515-1160
US

IV. Provider business mailing address

5291 ASHLEY CIR
YOUNGSTOWN OH
44515-1160
US

V. Phone/Fax

Practice location:
  • Phone: 330-793-3010
  • Fax:
Mailing address:
  • Phone: 330-793-3010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number1733N
License Number StateOH

VIII. Authorized Official

Name: MRS. DIANE J REESE
Title or Position: MEMBER-ADMINATRATOR
Credential:
Phone: 330-793-3010