Provider Demographics
NPI:1720121080
Name:ASCEND HOME CARE, LLC
Entity Type:Organization
Organization Name:ASCEND HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MATHEW
Authorized Official - Middle Name:
Authorized Official - Last Name:THOTTAPURAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-226-5884
Mailing Address - Street 1:2611 N BELT LINE RD
Mailing Address - Street 2:SUITE 105
Mailing Address - City:SUNNYVALE
Mailing Address - State:TX
Mailing Address - Zip Code:75182-9301
Mailing Address - Country:US
Mailing Address - Phone:972-226-5884
Mailing Address - Fax:972-203-8776
Practice Address - Street 1:2611 N BELT LINE RD
Practice Address - Street 2:SUITE 105
Practice Address - City:SUNNYVALE
Practice Address - State:TX
Practice Address - Zip Code:75182-9301
Practice Address - Country:US
Practice Address - Phone:972-226-5884
Practice Address - Fax:972-203-8776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-15
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX009163251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX673192Medicare Oscar/Certification