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General NPI Number Information
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NPI Number | 1598134637
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Entity Type | Organization
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Legal Business Name | ARDOR HOME CARE REGISTRY, INC.
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Dates
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Enumeration Date | 09/18/2015
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 4701 N FEDERAL HWY STE 302
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City | POMPANO BEACH
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State | FL
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Zip | 33064-6550
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Country | US
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Telephone | 954-582-9885
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Fax | 561-272-6713
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Provider Business Mailing Address
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Address Line | 258 SE 6TH AVE STE 5&6
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City | DELRAY BEACH
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State | FL
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Zip | 33483-5259
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Country | US
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Telephone | 561-279-9885
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Fax | 561-272-6713
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | LISA SUSAN SPITULNIK
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Credential |
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Telephone | 561-279-9885
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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 | 30211567
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | 30211567
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License Number State | FL
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