1558403535 NPI number — ATENDA HEALTHCARE SOLUTIONS

Table of content: (NPI 1558403535)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558403535 NPI number — ATENDA HEALTHCARE SOLUTIONS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATENDA HEALTHCARE SOLUTIONS
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1558403535
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15712 S.W. 41ST STREET SUITE 18
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DAVIE
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33331
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-318-1462
Provider Business Mailing Address Fax Number:
954-315-3027

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15712 SW 41ST ST STE 18
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DAVIE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33331-1538
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-318-1462
Provider Business Practice Location Address Fax Number:
954-315-3027
Provider Enumeration Date:
02/13/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ROGERS
Authorized Official First Name:
CHERI
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
954-318-1462

Provider Taxonomy Codes

  • Taxonomy code: 251B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)