Provider Demographics
NPI:1942711197
Name:ASA HOME HEALTH AND COMPANION SERVICES
Entity Type:Organization
Organization Name:ASA HOME HEALTH AND COMPANION SERVICES
Other - Org Name:SHEILA SMITH
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SHEILA
Authorized Official - Middle Name:E
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:CMA
Authorized Official - Phone:678-201-9543
Mailing Address - Street 1:8491 CEDAR CREEK RDG
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:GA
Mailing Address - Zip Code:30274-4558
Mailing Address - Country:US
Mailing Address - Phone:678-201-9543
Mailing Address - Fax:
Practice Address - Street 1:8491 CEDAR CREEK RDG
Practice Address - Street 2:
Practice Address - City:RIVERDALE
Practice Address - State:GA
Practice Address - Zip Code:30274-4558
Practice Address - Country:US
Practice Address - Phone:678-201-9543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-16
Last Update Date:2017-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174200000X, 251J00000X, 253Z00000X, 302R00000X, 305R00000X, 305S00000X, 332U00000X, 347C00000X
GABL-44067251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No174200000XOther Service ProvidersMeals
No251J00000XAgenciesNursing Care
No253Z00000XAgenciesIn Home Supportive Care
No302R00000XManaged Care OrganizationsHealth Maintenance Organization
No305R00000XManaged Care OrganizationsPreferred Provider Organization
No305S00000XManaged Care OrganizationsPoint of Service
No332U00000XSuppliersHome Delivered Meals
No347C00000XTransportation ServicesPrivate Vehicle