Provider Demographics
NPI:1518323724
Name:ASSURANCE HEALTHCARE SERVICES, LLC
Entity Type:Organization
Organization Name:ASSURANCE HEALTHCARE SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:PETER
Authorized Official - Middle Name:FRU
Authorized Official - Last Name:AKUFONGWE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-498-1461
Mailing Address - Street 1:4420 STARK PL
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-3960
Mailing Address - Country:US
Mailing Address - Phone:240-498-1461
Mailing Address - Fax:301-398-8312
Practice Address - Street 1:4420 STARK PL
Practice Address - Street 2:
Practice Address - City:ANNANDALE
Practice Address - State:VA
Practice Address - Zip Code:22003-3960
Practice Address - Country:US
Practice Address - Phone:240-498-1461
Practice Address - Fax:301-398-8312
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-05
Last Update Date:2016-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2464311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home