Provider Demographics
NPI:1639506439
Name:ASA HOME SERVICES, INC
Entity Type:Organization
Organization Name:ASA HOME SERVICES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:WILDOR
Authorized Official - Middle Name:
Authorized Official - Last Name:MERIVIL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-766-0595
Mailing Address - Street 1:2006 RALPH AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11234-5309
Mailing Address - Country:US
Mailing Address - Phone:347-766-0595
Mailing Address - Fax:
Practice Address - Street 1:2006 RALPH AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11234-5309
Practice Address - Country:US
Practice Address - Phone:347-766-0595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-11
Last Update Date:2016-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care