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General NPI Number Information
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NPI Number | 1801176250
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Entity Type | Organization
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Legal Business Name | ASG SERVICES LLC
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Dates
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Enumeration Date | 08/17/2011
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Last Update Date | 01/31/2013
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Provider Practice Location Address
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Address Line | 126 SCARBORO ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5742
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Country | US
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Telephone | 336-521-4627
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Fax |
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Provider Business Mailing Address
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Address Line | 126 SCARBORO ST
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City | ASHEBORO
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State | NC
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Zip | 27203-5742
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Country | US
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Telephone | 336-521-4627
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Fax |
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Authorized Official
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Title or Position | CFO
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Name | MR. DANIEL JEROME MCDUFFIE
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Credential |
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Telephone | 336-349-3839
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | MHL079119
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License Number State | NC
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