Provider Demographics
NPI:1669638821
Name:APPALACHIAN OUTPATIENT SERVICES
Entity type:Organization
Organization Name:APPALACHIAN OUTPATIENT SERVICES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:SASHA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:CALLOWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:704-860-8351
Mailing Address - Street 1:119 TUNNEL RD STE B
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28805-1800
Mailing Address - Country:US
Mailing Address - Phone:814-552-0229
Mailing Address - Fax:828-350-1300
Practice Address - Street 1:11 N COUNTRY CLUB RD
Practice Address - Street 2:
Practice Address - City:BREVARD
Practice Address - State:NC
Practice Address - Zip Code:28712-8908
Practice Address - Country:US
Practice Address - Phone:828-884-2475
Practice Address - Fax:828-884-2187
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-06
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251S00000X, 261QM0850X, 320800000X
NCMHL-045-121261QM0855X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health