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General NPI Number Information
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NPI Number | 1588175152
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Entity Type | Organization
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Legal Business Name | ASCENT HEALTH SERVICES LLC
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Dates
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Enumeration Date | 10/23/2017
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Last Update Date | 12/14/2017
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Provider Practice Location Address
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Address Line | 1211 N SHARTEL AVE
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City | OKLAHOMA CITY
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State | OK
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Zip | 73103-2400
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Country | US
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Telephone | 405-235-4442
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Fax | 405-235-4441
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Provider Business Mailing Address
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Address Line | 15909 CREEK HEIGHTS DR
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City | EDMOND
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State | OK
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Zip | 73013-9719
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Country | US
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Telephone | 405-219-0724
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Fax |
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Authorized Official
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Title or Position | OCCUPATIONAL THERAPIST / OWNER
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Name | GOPAKUMAR DAMAYANTHY
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Credential | O.T.
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Telephone | 405-219-0724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 1257
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License Number State | OK
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