Provider Demographics
NPI:1437388238
Name:ASFC,LLC
Entity type:Organization
Organization Name:ASFC,LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SECRETARY
Authorized Official - Prefix:MR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:JARED
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-237-8377
Mailing Address - Street 1:1715 S CEDAR AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93702-4331
Mailing Address - Country:US
Mailing Address - Phone:559-237-8377
Mailing Address - Fax:559-485-5768
Practice Address - Street 1:1715 S CEDAR AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93702-4331
Practice Address - Country:US
Practice Address - Phone:714-548-8046
Practice Address - Fax:714-388-3632
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ASPEN SKILLED HEALTHCARE, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-07-14
Last Update Date:2019-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA555866Medicare Oscar/Certification