Provider Demographics
NPI:1902949712
Name:ASCENSA HEALTH, INC.
Entity Type:Organization
Organization Name:ASCENSA HEALTH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAFFER
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:404-874-2224
Mailing Address - Street 1:139 RENAISSANCE PKWY NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2324
Mailing Address - Country:US
Mailing Address - Phone:404-874-2224
Mailing Address - Fax:404-874-2353
Practice Address - Street 1:139 RENAISSANCE PKWY NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30308-2324
Practice Address - Country:US
Practice Address - Phone:404-874-2224
Practice Address - Fax:404-874-2353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility