Provider Demographics
NPI:1619675808
Name:ASANTE HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ASANTE HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:DOMPREH
Authorized Official - Last Name:ASANTE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:774-578-7912
Mailing Address - Street 1:25 PRESTON ST
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-2124
Mailing Address - Country:US
Mailing Address - Phone:774-578-7912
Mailing Address - Fax:774-578-7912
Practice Address - Street 1:40 MECHANIC ST STE 305
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4425
Practice Address - Country:US
Practice Address - Phone:774-578-7912
Practice Address - Fax:774-578-7912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-17
Last Update Date:2023-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA88-272409OtherNONE