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General NPI Number Information
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NPI Number | 1003203506
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Entity Type | Organization
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Legal Business Name | ARCH CREEK SENIOR CARE SERVICES INCORPORATED
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 09/13/2017
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Provider Practice Location Address
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Address Line | 13899 BISCAYNE BLVD SUITE 228
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33181-1600
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Country | US
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Telephone | 786-916-0661
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Fax |
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Provider Business Mailing Address
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Address Line | 2065 NE 163 STREET
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162
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Country | US
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Telephone | 305-944-0663
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Fax | 305-944-0662
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Authorized Official
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Title or Position | OWNER/ADMINISTRATOR
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Name | MS. CASSANDRA LANNETTE STURRUP
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Credential | RN
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Telephone | 786-916-0661
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 233757
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License Number State | FL
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