Provider Demographics
NPI:1417550757
Name:ASHLEN ENTERPRISES, LLC
Entity Type:Organization
Organization Name:ASHLEN ENTERPRISES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:VALOSHA
Authorized Official - Middle Name:ASHLEIGH
Authorized Official - Last Name:ODOM
Authorized Official - Suffix:
Authorized Official - Credentials:MBA
Authorized Official - Phone:336-554-3092
Mailing Address - Street 1:PO BOX 1273
Mailing Address - Street 2:
Mailing Address - City:JAMESTOWN
Mailing Address - State:NC
Mailing Address - Zip Code:27282-1273
Mailing Address - Country:US
Mailing Address - Phone:772-828-9083
Mailing Address - Fax:
Practice Address - Street 1:105 BRANTMERE CT
Practice Address - Street 2:
Practice Address - City:JAMESTOWN
Practice Address - State:NC
Practice Address - Zip Code:27282-8404
Practice Address - Country:US
Practice Address - Phone:336-554-3092
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASHLEN ENTERPRISES, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-11-19
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care