Provider Demographics
NPI:1285814103
Name:ASHEVILLE HEALTHCARE LLC
Entity Type:Organization
Organization Name:ASHEVILLE HEALTHCARE LLC
Other - Org Name:GRACE HEALTHCARE OF ASHEVILLE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE
Authorized Official - Prefix:MRS
Authorized Official - First Name:ALICE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CLARK DANKS
Authorized Official - Suffix:
Authorized Official - Credentials:CPS
Authorized Official - Phone:423-308-1845
Mailing Address - Street 1:91 VICTORIA RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4427
Mailing Address - Country:US
Mailing Address - Phone:828-255-0076
Mailing Address - Fax:828-285-0437
Practice Address - Street 1:91 VICTORIA RD
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4427
Practice Address - Country:US
Practice Address - Phone:828-255-0076
Practice Address - Fax:828-285-0437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-08
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCNH0233314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3426157Medicaid
NC3425174Medicaid
NC3426157Medicaid