Provider Demographics
NPI:1659162428
Name:ASCENSION HOME CARE & STAFFING LLC
Entity type:Organization
Organization Name:ASCENSION HOME CARE & STAFFING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SUZETTE
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-927-8751
Mailing Address - Street 1:3355 N WHITE AVE UNIT 381
Mailing Address - Street 2:
Mailing Address - City:LA VERNE
Mailing Address - State:CA
Mailing Address - Zip Code:91750-6117
Mailing Address - Country:US
Mailing Address - Phone:310-927-8751
Mailing Address - Fax:
Practice Address - Street 1:500 MARQUETTE AVE NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87102-5340
Practice Address - Country:US
Practice Address - Phone:310-927-8751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-13
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care