Provider Demographics
NPI:1609070812
Name:THE VILLAGE OF ASHE ASSISTED LIVING INC
Entity type:Organization
Organization Name:THE VILLAGE OF ASHE ASSISTED LIVING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:H
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:336-846-1008
Mailing Address - Street 1:PO BOX 429
Mailing Address - Street 2:
Mailing Address - City:WEST JEFFERSON
Mailing Address - State:NC
Mailing Address - Zip Code:28694
Mailing Address - Country:US
Mailing Address - Phone:336-846-1008
Mailing Address - Fax:336-846-1147
Practice Address - Street 1:151 VILLAGE PARK DRIVE
Practice Address - Street 2:
Practice Address - City:WEST JEFFERSON
Practice Address - State:NC
Practice Address - Zip Code:28694
Practice Address - Country:US
Practice Address - Phone:336-846-1008
Practice Address - Fax:336-846-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-12
Last Update Date:2007-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCHAL005008310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7805568Medicaid