Provider Demographics
NPI:1669529673
Name:ASHE SERVICES FOR AGING, INC
Entity type:Organization
Organization Name:ASHE SERVICES FOR AGING, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:336-246-2461
Mailing Address - Street 1:180 CHATTY ROB LN
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694-9365
Mailing Address - Country:US
Mailing Address - Phone:336-246-2461
Mailing Address - Fax:336-246-5724
Practice Address - Street 1:180 CHATTY ROB LN
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694-9365
Practice Address - Country:US
Practice Address - Phone:336-246-2461
Practice Address - Fax:336-246-5724
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-04
Last Update Date:2024-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCSL001011251V00000X
NCCERTIFICATE261QM3000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM3000XAmbulatory Health Care FacilitiesClinic/CenterMedically Fragile Infants and Children Day Care
No251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8300174KMedicaid
NC8300174Medicaid