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General NPI Number Information
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NPI Number | 1164819652
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Entity Type | Organization
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Legal Business Name | ARBOR FACILITY INC
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Dates
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Enumeration Date | 04/22/2015
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Last Update Date | 10/23/2018
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Provider Practice Location Address
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Address Line | 490 S OLD WIRE RD
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City | WILDWOOD
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State | FL
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Zip | 34785-5001
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Country | US
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Telephone | 352-748-3322
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Fax |
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Provider Business Mailing Address
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Address Line | 4302 HOLLYWOOD BLVD #369
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City | HOLLYWOOD
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State | FL
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Zip | 33021-6635
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED REPRESENTATIVE
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Name | MR. MICHAEL BLEICH
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Credential |
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Telephone | 845-641-8314
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 314000000X
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Taxonomy Name | Skilled Nursing Facility
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License Number | SNF1588096
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License Number State | FL
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