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General NPI Number Information
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NPI Number | 1720945710
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Entity Type | Organization
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Legal Business Name | ASA LIFECARE OF CANTON 2, LLC
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Dates
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Enumeration Date | 01/09/2026
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Last Update Date | 01/09/2026
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Provider Practice Location Address
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Address Line | 1711 48TH ST NW
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City | CANTON
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State | OH
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Zip | 44709-1221
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Country | US
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Telephone | 330-919-7779
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 289
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City | LOUISVILLE
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State | OH
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Zip | 44641-0289
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Country | US
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Telephone | 330-919-7779
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | TYLER BOND
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Credential |
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Telephone | 330-919-7779
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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