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General NPI Number Information
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NPI Number | 1245600808
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Entity Type | Organization
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Legal Business Name | ALOYS ASONG
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Dates
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Enumeration Date | 09/25/2015
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Last Update Date | 09/25/2015
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Provider Practice Location Address
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Address Line | 771 KOLLINES CT
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City | BLACKLICK
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State | OH
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Zip | 43004-8424
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Country | US
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Telephone | 614-282-9078
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Fax |
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Provider Business Mailing Address
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Address Line | 771 KOLLINES CT
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City | BLACKLICK
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State | OH
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Zip | 43004-8424
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALOYS ASONG
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Credential |
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Telephone | 614-282-9078
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3140N1450X
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Taxonomy Name | Pediatric Skilled Nursing Facility
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License Number | 158802-M-IV
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License Number State | OH
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