Provider Demographics
NPI:1235496423
Name:AMERICAN SPECIALTY HEALTH GROUP OF SOUTH DAKOTA
Entity Type:Organization
Organization Name:AMERICAN SPECIALTY HEALTH GROUP OF SOUTH DAKOTA
Other - Org Name:AMERICAN SPECIALITY HEALTH NETWORKS OF SOUTH DAKOTA, INC. DBA ASH NETW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:CHIEF HEALTH SERVICES OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:R.
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:METZ
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:800-848-3555
Mailing Address - Street 1:10221 WATERIDGE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92121
Mailing Address - Country:US
Mailing Address - Phone:800-848-3555
Mailing Address - Fax:877-414-2746
Practice Address - Street 1:10221 WATERIDGE CIRCLE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92121
Practice Address - Country:US
Practice Address - Phone:800-848-3555
Practice Address - Fax:877-414-2746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-12
Last Update Date:2023-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Multi-Specialty