MEDICARE: ARTHUR RESIDENTIAL HOMES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QD1600X	Developmental Disabilities Clinic/Center

General Provider Information

NPI Number	:	1053186593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARTHUR RESIDENTIAL HOMES LLC

Provider Business Mailing Address
First Line	:	1611 GOULD RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1611 GOULD RD
Second Line	:
City	:	TOLEDO
State	:	OH
Zip	:	43612-2022
Country	:	US
Telephone Number	:	419-343-8971
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	SIMONE MCBRIDE
Credential	:
Telephone Number	:	419-343-8971

Provider Enumeration Date	:	11/15/2023
Last Update Date	:	11/15/2023

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