Provider Demographics
NPI:1871254136
Name:ASI COMMUNITY WELLNESS GROUP
Entity Type:Organization
Organization Name:ASI COMMUNITY WELLNESS GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:REBEKAH
Authorized Official - Middle Name:
Authorized Official - Last Name:BOTELLO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-845-3628
Mailing Address - Street 1:127 QUICK RD
Mailing Address - Street 2:
Mailing Address - City:NEW CARLISLE
Mailing Address - State:OH
Mailing Address - Zip Code:45344-9253
Mailing Address - Country:US
Mailing Address - Phone:937-845-3628
Mailing Address - Fax:
Practice Address - Street 1:501 S WITTENBERG AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45506-2101
Practice Address - Country:US
Practice Address - Phone:937-342-3029
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ADMIN SOLUTIONS, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-01-07
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health