Provider Demographics
NPI:1649031378
Name:A&J ASAGAO
Entity type:Organization
Organization Name:A&J ASAGAO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSEE/ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:ANNE LOUISE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAKINOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:661-390-8324
Mailing Address - Street 1:45701 17TH ST W
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:CA
Mailing Address - Zip Code:93534-5156
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:45701 17TH ST W
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-5156
Practice Address - Country:US
Practice Address - Phone:661-390-8324
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-19
Last Update Date:2024-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility