Provider Demographics
NPI:1144035346
Name:ARVADA HEALTH LLC
Entity type:Organization
Organization Name:ARVADA HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING SPECIALIST
Authorized Official - Prefix:
Authorized Official - First Name:KACEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CALLISON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:725-710-9224
Mailing Address - Street 1:30100 CHAGRIN BLVD
Mailing Address - Street 2:
Mailing Address - City:PEPPER PIKE
Mailing Address - State:OH
Mailing Address - Zip Code:44124-5722
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:702-977-1496
Practice Address - Street 1:30100 CHAGRIN BLVD
Practice Address - Street 2:
Practice Address - City:PEPPER PIKE
Practice Address - State:OH
Practice Address - Zip Code:44124-5722
Practice Address - Country:US
Practice Address - Phone:732-703-3113
Practice Address - Fax:702-977-1496
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WW0000XNursing Service ProvidersRegistered NurseWound CareGroup - Multi-Specialty