Provider Demographics
NPI:1710922430
Name:ASCENTIA HOME HEALTH CARE, LLC
Entity Type:Organization
Organization Name:ASCENTIA HOME HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:C.F.O./OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COLLIGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:727-723-1233
Mailing Address - Street 1:2495 ENTERPRISE RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33763-1795
Mailing Address - Country:US
Mailing Address - Phone:727-723-1233
Mailing Address - Fax:727-723-1455
Practice Address - Street 1:2495 ENTERPRISE RD
Practice Address - Street 2:SUITE 101
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33763-1795
Practice Address - Country:US
Practice Address - Phone:727-723-1233
Practice Address - Fax:727-723-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL108110Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER