Healthcare Provider Details

I. General information

NPI: 1114002128
Provider Name (Legal Business Name): ASANTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 02/22/2024
Certification Date: 02/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 E BARNETT RD
MEDFORD OR
97504-8332
US

IV. Provider business mailing address

PO BOX 4749
MEDFORD OR
97501-0227
US

V. Phone/Fax

Practice location:
  • Phone: 541-789-7000
  • Fax: 541-789-5393
Mailing address:
  • Phone: 541-789-5516
  • Fax: 541-789-5518

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273R00000X
TaxonomyPsychiatric Hospital Unit
License Number
License Number State

VIII. Authorized Official

Name: HEATHER J ROWENHORST
Title or Position: CFO
Credential:
Phone: 541-789-4549