Provider Demographics
NPI:1750682100
Name:ASPERA HEALTHCARE SERVICES,LLC
Entity Type:Organization
Organization Name:ASPERA HEALTHCARE SERVICES,LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:RUKAYAT
Authorized Official - Middle Name:
Authorized Official - Last Name:HARDEMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:770-309-6922
Mailing Address - Street 1:1080 CAMBRIDGE SQ
Mailing Address - Street 2:SUITE B
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30009-1878
Mailing Address - Country:US
Mailing Address - Phone:770-667-9778
Mailing Address - Fax:770-667-9774
Practice Address - Street 1:1080 CAMBRIDGE SQ
Practice Address - Street 2:SUITE B
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30009-1878
Practice Address - Country:US
Practice Address - Phone:770-667-9778
Practice Address - Fax:770-667-9774
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-16
Last Update Date:2010-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA060-R-0784251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health