Provider Demographics
NPI:1528646890
Name:ASHLYNN HOME CARE
Entity type:Organization
Organization Name:ASHLYNN HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DONTAVIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:PROVOST
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-739-5631
Mailing Address - Street 1:10770 BARELY LN APT 117
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-5963
Mailing Address - Country:US
Mailing Address - Phone:832-739-5631
Mailing Address - Fax:
Practice Address - Street 1:3050 POST OAK BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77056-6527
Practice Address - Country:US
Practice Address - Phone:832-739-5631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Multi-Specialty