Provider Demographics
NPI:1275681553
Name:ASANTE COMMUNITY SERVICES LLC
Entity Type:Organization
Organization Name:ASANTE COMMUNITY SERVICES LLC
Other - Org Name:ASANTE LIFELINE
Other - Org Type:Other Name
Authorized Official - Title/Position:CAFO
Authorized Official - Prefix:
Authorized Official - First Name:GREG
Authorized Official - Middle Name:G
Authorized Official - Last Name:WOJTAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:541-789-4549
Mailing Address - Street 1:500 SW RAMSEY AVENUE
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5554
Mailing Address - Country:US
Mailing Address - Phone:541-507-2680
Mailing Address - Fax:
Practice Address - Street 1:700 SW RAMSEY
Practice Address - Street 2:SUITE 101
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5554
Practice Address - Country:US
Practice Address - Phone:541-507-2680
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR298523Medicaid