Basic Information
| Provider Information | |||||||||
| NPI: | 1124266457 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARKWAY BEAHVIORAL HEALTH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 31 COLLEGE PLACE | ||||||||
| Address2: | B100 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288012400 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282545008 | ||||||||
| FaxNumber: | 8282545808 | ||||||||
| Practice Location | |||||||||
| Address1: | 271 CALLAHAN KOON RD | ||||||||
| Address2: | |||||||||
| City: | SPINDALE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 281602207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282888773 | ||||||||
| FaxNumber: | 8282889577 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2009 | ||||||||
| LastUpdateDate: | 03/24/2009 | ||||||||
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| AuthorizedOfficialLastName: | GREEN | ||||||||
| AuthorizedOfficialFirstName: | LORI | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING | ||||||||
| AuthorizedOfficialTelephone: | 8282545008 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251S00000X | MHL081072 | NC | Y | Agencies | Community/Behavioral Health |
ID Information
| ID | Type | State | Issuer | Description | 018PV | 01 | NC | BCBS | OTHER | 8301722 | 05 | NC | MEDICAID | 8301722F | 05 | NC | MEDICAID | 8301722G | 05 | NC | MEDICAID | 8301722Q | 05 | NC | MEDICAID | 8301722B | 05 | NC | MEDICAID |