Provider Demographics
NPI:1548618754
Name:ARRUDA, LUIS
Entity Type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:ARRUDA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MYLES STANDISH DR
Mailing Address - Street 2:
Mailing Address - City:NORTH DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-3827
Mailing Address - Country:US
Mailing Address - Phone:774-263-7796
Mailing Address - Fax:
Practice Address - Street 1:22 MYLES STANDISH DR
Practice Address - Street 2:
Practice Address - City:NORTH DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-3827
Practice Address - Country:US
Practice Address - Phone:774-263-7796
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-27
Last Update Date:2016-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3741310400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility