Provider Demographics
NPI:1154490670
Name:PARKWAY BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:PARKWAY BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAYTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:828-254-5008
Mailing Address - Street 1:31 COLLEGE PL
Mailing Address - Street 2:B100
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-2400
Mailing Address - Country:US
Mailing Address - Phone:828-254-5008
Mailing Address - Fax:828-254-5808
Practice Address - Street 1:120 S GROVE ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28792-4007
Practice Address - Country:US
Practice Address - Phone:828-697-2660
Practice Address - Fax:828-697-2986
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-07
Last Update Date:2009-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCMHL045072251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6005970Medicaid
NC018PVOtherBCBS
NC018PVOtherBCBS