MEDICARE: ASA OPCO MANAGEMENT, 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
1	310400000X	Assisted Living Facility

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447871165
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASA OPCO MANAGEMENT, LLC

Provider Business Mailing Address
First Line	:	2745 NE 184TH WAY
Second Line	:
City	:	AVENTURA
State	:	FL
Zip	:	33160-2083
Country	:	US
Telephone Number	:	914-548-7617
Fax Number	:

Provider Business Practice Location Address
First Line	:	15520 NW 2ND AVE
Second Line	:
City	:	NORTH MIAMI BEACH
State	:	FL
Zip	:	33169-6710
Country	:	US
Telephone Number	:	914-548-7617
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	STEVEN BICKY
Credential	:
Telephone Number	:	914-548-7617

Provider Enumeration Date	:	05/04/2020
Last Update Date	:	05/04/2020

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Directions to “ASA OPCO MANAGEMENT, LLC ” Practice Location

Language	Start Address	Practice Location

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