Provider Demographics
NPI:1598413171
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:INFORMATION COORDINATOR
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:
Mailing Address - City:CEDAR BLUFF
Mailing Address - State:VA
Mailing Address - Zip Code:24609-0765
Mailing Address - Country:US
Mailing Address - Phone:276-964-4915
Mailing Address - Fax:276-963-0130
Practice Address - Street 1:555 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MARION
Practice Address - State:VA
Practice Address - Zip Code:24354-2413
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, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-03-14
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care