Healthcare Provider Details

I. General information

NPI: 1144793019
Provider Name (Legal Business Name): ASSOCIATED SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1609 WOODBOURNE RD STE 204A
LEVITTOWN PA
19057-1534
US

IV. Provider business mailing address

1609 WOODBOURNE RD STE 204A
LEVITTOWN PA
19057-1534
US

V. Phone/Fax

Practice location:
  • Phone: 732-887-8600
  • Fax:
Mailing address:
  • Phone: 732-887-8600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code261QR0800X
TaxonomyRecovery Care Clinic/Center
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateNULL
# 4
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number StateNULL
# 5
Primary TaxonomyN
Taxonomy Code174200000X
TaxonomyMeals Provider
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. SHAHID AJMERI
Title or Position: CEO
Credential: MBA
Phone: 732-887-8600