Provider Demographics
NPI:1457920951
Name:APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC
Entity Type:Organization
Organization Name:APPALACHIAN AGENCY FOR SENIOR CITIZENS, INC
Other - Org Name:MOUNT ROGERS PACE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:NETTIE
Authorized Official - Middle Name:REGINA
Authorized Official - Last Name:SAYERS
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?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-21
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251T00000XAgenciesProgram of All-Inclusive Care for the Elderly (PACE) Provider Organization
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care