Provider Demographics
NPI:1114052826
Name:ASSURANCE CARE PROVIDER, LLC
Entity Type:Organization
Organization Name:ASSURANCE CARE PROVIDER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:
Authorized Official - Last Name:TASSIN
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:504-472-0068
Mailing Address - Street 1:ASSURANCE CARE PROVIDER, LLC
Mailing Address - Street 2:2145 REVEREND RICHARD WILSON DR.
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70062-7606
Mailing Address - Country:US
Mailing Address - Phone:504-472-0078
Mailing Address - Fax:504-472-0068
Practice Address - Street 1:ASSURANCE CARE PROVIDER, LLC
Practice Address - Street 2:2145 REVEREND RICHARD WILSON DR.
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-7606
Practice Address - Country:US
Practice Address - Phone:504-472-0078
Practice Address - Fax:504-472-0068
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-22
Last Update Date:2019-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1174998251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health