Provider Demographics
NPI:1144982745
Name:ASCENCIA
Entity type:Organization
Organization Name:ASCENCIA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:HOSPITAL LIAISON
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:COLE
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:818-863-0781
Mailing Address - Street 1:1851 TYBURN ST
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91204-2900
Mailing Address - Country:US
Mailing Address - Phone:818-863-0781
Mailing Address - Fax:818-246-2858
Practice Address - Street 1:1851 TYBURN ST
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91204-2900
Practice Address - Country:US
Practice Address - Phone:818-246-7900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty
No251B00000XAgenciesCase ManagementGroup - Multi-Specialty
No251E00000XAgenciesHome Health
No251X00000XAgenciesSupports Brokerage
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty