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NPI Code Detail

MEDICARE: ASCEND BEHAVIORAL HEALTH SERVICES LLC

MEDICARE: ASCEND BEHAVIORAL HEALTH SERVICES LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number : 1407403397
Entity Type Code : Organization
Provider Name (Legal Business Name) : ASCEND BEHAVIORAL HEALTH SERVICES LLC
Provider Business Mailing Address
First Line : 6360 PRESIDENTIAL CT STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-3501
Country : US
Telephone Number : 786-373-3027
Fax Number : 786-802-2011
Provider Business Practice Location Address
First Line : 6360 PRESIDENTIAL CT STE 1
Second Line :
City : FORT MYERS
State : FL
Zip : 33919-3501
Country : US
Telephone Number : 786-373-3027
Fax Number : 786-802-2011
Authorized Official
Title or Position : PRESIDENT
Name : DAVID O ROQUE
Credential : PA
Telephone Number : 786-373-3027
Provider Enumeration Date : 08/24/2019
Last Update Date : 01/14/2026

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Directions to “ASCEND BEHAVIORAL HEALTH SERVICES LLC ” Practice Location

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