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General NPI Number Information
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NPI Number | 1518353515
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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 | 04/07/2015
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Last Update Date | 02/01/2021
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Provider Practice Location Address
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Address Line | 1810 NE 153RD ST STE 3
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-6004
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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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Provider Business Mailing Address
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Address Line | 1810 NE 153RD ST STE 3
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City | NORTH MIAMI BEACH
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State | FL
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Zip | 33162-6004
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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 | 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 | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 299994365
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License Number State | FL
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