Healthcare Provider Details

I. General information

NPI: 1396367041
Provider Name (Legal Business Name): ARHC ARCLRMI01 TRS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/15/2020
Last Update Date: 01/03/2023
Certification Date: 12/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5700 WATER TOWER PL
CLARKSTON MI
48346-2668
US

IV. Provider business mailing address

PO BOX 600
YORK ME
03909-0600
US

V. Phone/Fax

Practice location:
  • Phone: 617-648-6814
  • Fax:
Mailing address:
  • Phone: 617-648-6814
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code311500000X
TaxonomyAlzheimer Center (Dementia Center)
License Number
License Number State

VIII. Authorized Official

Name: PATRICK J COLLINS
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 442-325-4038