1578589180 NPI number — ARCADIA HEALTH SERVICES, INC.

Table of content: (NPI 1578589180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578589180 NPI number — ARCADIA HEALTH SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARCADIA HEALTH SERVICES, 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:
1578589180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20750 CIVIC CENTER DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
SOUTHFIELD
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48076-4152
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-733-8427
Provider Business Mailing Address Fax Number:
248-352-5189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7340 SIX FORKS RD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27615-5282
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-846-9212
Provider Business Practice Location Address Fax Number:
919-848-2496
Provider Enumeration Date:
07/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SPARLING
Authorized Official First Name:
CATHY
Authorized Official Middle Name:
WEISS
Authorized Official Title or Position:
CHIEF OPERATING OFFICER
Authorized Official Telephone Number:
800-733-8427

Provider Taxonomy Codes

  • Taxonomy code: 251J00000X , with the licence number:  HC2297 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: HC2297 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3408529 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".
  • Identifier: 6600935 , issued by the state of ( NC ) . This identifiers is of the category "MEDICAID".




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