Provider Demographics
NPI:1891138319
Name:ASCENDANT HOME HEALTH CARE LLC
Entity Type:Organization
Organization Name:ASCENDANT HOME HEALTH CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:JIMMENELL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAIRSTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:717-686-4123
Mailing Address - Street 1:1205 S 28TH ST
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17111-1046
Mailing Address - Country:US
Mailing Address - Phone:717-686-4123
Mailing Address - Fax:717-565-2276
Practice Address - Street 1:1205 S 28TH ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17111-1046
Practice Address - Country:US
Practice Address - Phone:717-686-4123
Practice Address - Fax:717-565-2276
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-15
Last Update Date:2014-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA03100501251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA398102Medicare Oscar/Certification