Provider Demographics
NPI:1346953171
Name:CITIZENS SCHOOL OF NURSING INC
Entity Type:Organization
Organization Name:CITIZENS SCHOOL OF NURSING INC
Other - Org Name:CITIZENS SENIOR CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:ARCHIBONG
Authorized Official - Last Name:JACK
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:919-633-9397
Mailing Address - Street 1:4220 BEACON CREST WAY
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27604-8318
Mailing Address - Country:US
Mailing Address - Phone:919-633-9397
Mailing Address - Fax:
Practice Address - Street 1:601 BRICKELL KEY DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2662
Practice Address - Country:US
Practice Address - Phone:786-620-3489
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITIZENS SCHOOL OF NURSING INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-12-26
Last Update Date:2023-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff DevelopmentGroup - Single Specialty
No163WC1400XNursing Service ProvidersRegistered NurseCollege HealthGroup - Multi-Specialty
No251J00000XAgenciesNursing CareGroup - Multi-Specialty
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty
No376K00000XNursing Service Related ProvidersNurse's AideGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP22000087784OtherFLORIDA SECRETARY OF STATE