Provider Demographics
NPI:1225377757
Name:APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC
Entity Type:Organization
Organization Name:APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING/CREDENTIALING
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:BARBOUR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:276-964-4915
Mailing Address - Street 1:PO BOX 765
Mailing Address - Street 2:216 COLLEGE RIDGE RD
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-0765
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 COLLEGE RIDGE RD.
Practice Address - Street 2:
Practice Address - City:CEDAR BLUFF
Practice Address - State:VA
Practice Address - Zip Code:24609-0765
Practice Address - Country:US
Practice Address - Phone:276-964-4915
Practice Address - Fax:276-963-0130
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPALACHIAN AGENCY FOR SENIOR CITIZENS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-02-04
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251B00000X, 253Z00000X, 385H00000X
VAADC1103638261QA0600X
VAADC958134261QA0600X
VAHCO-187633747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Multi-Specialty
No251B00000XAgenciesCase Management
No253Z00000XAgenciesIn Home Supportive Care
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day CareGroup - Multi-Specialty
No385H00000XRespite Care FacilityRespite CareGroup - Multi-Specialty