Provider Demographics
NPI:1598387557
Name:ASCEND DIAGNOSTIC & SUPPORT SERVICES
Entity Type:Organization
Organization Name:ASCEND DIAGNOSTIC & SUPPORT SERVICES
Other - Org Name:ASCEND DIAGNOSTIC & SUPPORT SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HALEIGH
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:330-317-9274
Mailing Address - Street 1:9311 DEFIANCE CIR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1011
Mailing Address - Country:US
Mailing Address - Phone:330-317-9274
Mailing Address - Fax:
Practice Address - Street 1:2717 COTTAGE WAY STE 16&17
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-1232
Practice Address - Country:US
Practice Address - Phone:916-913-1542
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-13
Last Update Date:2020-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Multi-Specialty