MEDICARE: ARCHWAYS, INC

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	101YM0800X	Mental Health Counselor
2	104100000X	Social Worker
3	1041C0700X	Clinical Social Worker
4	2084P0800X	Psychiatry Physician
5	251B00000X	Case Management Agency	1006AD199301	FL
6	363LP0808X	Psychiatric/Mental Health Nurse Practitioner
7	251S00000X	Community/Behavioral Health Agency

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	060497608	OTHER	FL	MEDICARE CROSSOVER

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316982408
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCHWAYS, INC

Provider Business Mailing Address
First Line	:	919 NE 13TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-2009
Country	:	US
Telephone Number	:	954-763-2030
Fax Number	:	954-763-9847

Provider Business Practice Location Address
First Line	:	919 NE 13TH ST
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33304-2009
Country	:	US
Telephone Number	:	954-763-2030
Fax Number	:	954-763-9847

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR/CEO
Name	:	MARIE FAIRCHILD
Credential	:	CSW
Telephone Number	:	954-763-2030

Provider Enumeration Date	:	06/20/2006
Last Update Date	:	06/20/2025

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Directions to “ARCHWAYS, INC ” Practice Location

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