1912025545 NPI number — ARCADIA HEALTHCARE SOLUTIONS, INC.

Table of content: BETH MARIE CLARKE LMT (NPI 1720114655)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912025545 NPI number — ARCADIA HEALTHCARE SOLUTIONS, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCADIA HEALTHCARE SOLUTIONS, INC.
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:
6
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:
1912025545
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26777 CENTRAL PARK BLVD
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48076-4162
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-352-7530
Provider Business Mailing Address Fax Number:
248-352-5189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5851 NW 177TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HIALEAH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33015-5127
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
303-828-2500
Provider Business Practice Location Address Fax Number:
305-828-6500
Provider Enumeration Date:
03/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SPARLING
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
Authorized Official Title or Position:
VP ADMINISTRATIVE SERVICES
Authorized Official Telephone Number:
248-352-7530

Provider Taxonomy Codes

  • Taxonomy code: 332BX2000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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