Provider Demographics
NPI:1902272438
Name:ASH OPERATOR GROUP LLC
Entity Type:Organization
Organization Name:ASH OPERATOR GROUP LLC
Other - Org Name:GUARDIAN HEALTHCARE AND REHABILITATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DAWNE
Authorized Official - Middle Name:R
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:318-812-2140
Mailing Address - Street 1:101 N 2ND ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WEST MONROE
Mailing Address - State:LA
Mailing Address - Zip Code:71291-3266
Mailing Address - Country:US
Mailing Address - Phone:318-812-2140
Mailing Address - Fax:318-812-2143
Practice Address - Street 1:1401 COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-5321
Practice Address - Country:US
Practice Address - Phone:337-480-1550
Practice Address - Fax:337-480-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-19
Last Update Date:2015-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA195636Medicare Oscar/Certification