Provider Demographics
NPI:1972944874
Name:ARHC BTFMYFL01 TRS, LLC
Entity type:Organization
Organization Name:ARHC BTFMYFL01 TRS, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MR
Authorized Official - First Name:JUDD
Authorized Official - Middle Name:
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-237-4509
Mailing Address - Street 1:3715 NORTHSIDE PKWY NW
Mailing Address - Street 2:BUILDING 300, SUITE 110
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30327-2806
Mailing Address - Country:US
Mailing Address - Phone:404-237-4509
Mailing Address - Fax:
Practice Address - Street 1:9731 COMMERCE CENTER CT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33908-1400
Practice Address - Country:US
Practice Address - Phone:239-334-2500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-09
Last Update Date:2013-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL10100310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL692481600Medicaid