Provider Demographics
NPI:1689120297
Name:ARCH HOME CARE
Entity Type:Organization
Organization Name:ARCH HOME CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:PRESLEE
Authorized Official - Middle Name:
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:937-343-1706
Mailing Address - Street 1:2820 S. COUNTY LINE RD 25A
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45377
Mailing Address - Country:US
Mailing Address - Phone:937-343-1706
Mailing Address - Fax:888-247-4477
Practice Address - Street 1:2820 S. COUNTY LINE RD 25A
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45377
Practice Address - Country:US
Practice Address - Phone:937-343-1706
Practice Address - Fax:888-247-4477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH1801234307Medicaid