Healthcare Provider Details
I. General information
NPI: 1003105404
Provider Name (Legal Business Name): ASCENSION ASSISTIVE SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/06/2011
Last Update Date: 04/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
336 TEXAS ST
CEDAR HILL TX
75104-2612
US
IV. Provider business mailing address
336 TEXAS ST
CEDAR HILL TX
75104-2612
US
V. Phone/Fax
- Phone: 972-637-3473
- Fax:
- Phone: 972-637-3473
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 302F00000X |
| Taxonomy | Exclusive Provider Organization |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MS.
VERNITA
J
WEBB
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 972-637-3473