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General NPI Number Information
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NPI Number | 1154657666
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Entity Type | Organization
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Legal Business Name | ABI ARBOR
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Dates
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Enumeration Date | 10/19/2009
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Last Update Date | 10/19/2009
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Provider Practice Location Address
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Address Line | 25 PINE CONE DR SUITE 4
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City | PALM COAST
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State | FL
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Zip | 32164-8423
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Country | US
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Telephone | 386-446-7796
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Fax | 386-597-4874
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Provider Business Mailing Address
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Address Line | PO BOX 352530
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City | PALM COAST
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State | FL
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Zip | 32135-2530
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Country | US
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Telephone | 386-446-7796
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Fax | 386-597-4874
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Authorized Official
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Title or Position | DIRECTOR OF OPERATIONS
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Name | MS. SHERRI SOMMERS
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Credential | RN, BSN
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Telephone | 386-446-7796
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number | 2925
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License Number State | FL
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