Basic Information
| Provider Information | |||||||||
| NPI: | 1578589180 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | ARCADIA HEALTH SERVICES, INC. | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | ARCADIA HOME CARE & STAFFING | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 20750 CIVIC CENTER DR | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SOUTHFIELD | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480764152 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8007338427 | ||||||||
| FaxNumber: | 2483525189 | ||||||||
| Practice Location | |||||||||
| Address1: | 7340 SIX FORKS RD | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | RALEIGH | ||||||||
| State: | NC | ||||||||
| PostalCode: | 276155282 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9198469212 | ||||||||
| FaxNumber: | 9198482496 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/15/2006 | ||||||||
| LastUpdateDate: | 07/22/2013 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SPARLING | ||||||||
| AuthorizedOfficialFirstName: | CATHY | ||||||||
| AuthorizedOfficialMiddleName: | WEISS | ||||||||
| AuthorizedOfficialTitleorPosition: | CHIEF OPERATING OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 8007338427 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | ARCADIA SERVICES, INC | ||||||||
| AuthorizedOfficialNamePrefix: | MS. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 251J00000X | HC2297 | NC | N | Agencies | Nursing Care | 251E00000X | HC2297 | NC | Y | Agencies | Home Health |
ID Information
| ID | Type | State | Issuer | Description | 3408529 | 05 | NC | MEDICAID | 6600935 | 05 | NC | MEDICAID |