Basic Information
| Provider Information | |||||||||
| NPI: | 1922233634 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SKYLAND BEHAVIORAL HEALTH ASSOCIATES | ||||||||
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| OtherOrganizationName: | SKYLAND BEHAVIORAL MEDICINE | ||||||||
| OtherOrganizationType: | 4 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 OAK PLZ | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288013008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282522501 | ||||||||
| FaxNumber: | 8282522701 | ||||||||
| Practice Location | |||||||||
| Address1: | 1 OAK PLZ | ||||||||
| Address2: | SUITE 206 | ||||||||
| City: | ASHEVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 288013008 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282522501 | ||||||||
| FaxNumber: | 8282522701 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/26/2009 | ||||||||
| LastUpdateDate: | 05/26/2009 | ||||||||
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| AuthorizedOfficialLastName: | SCOTT | ||||||||
| AuthorizedOfficialFirstName: | HEATHER | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8282530643 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2080P0006X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pediatrics | Developmental – Behavioral Pediatrics | 2084P0800X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 890248Q | 05 | NC | MEDICAID |