Provider Demographics
NPI:1508364811
Name:ASHTON HOMES, LLC
Entity Type:Organization
Organization Name:ASHTON HOMES, LLC
Other - Org Name:ASHTON HOMES, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:SEKOU
Authorized Official - Middle Name:A M
Authorized Official - Last Name:DUKULY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:763-321-0351
Mailing Address - Street 1:3300 COUNTY ROAD 10 STE 314
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55429-3066
Mailing Address - Country:US
Mailing Address - Phone:763-321-0351
Mailing Address - Fax:
Practice Address - Street 1:4913 WINCHESTER LN
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55429-1637
Practice Address - Country:US
Practice Address - Phone:763-354-0850
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health