Provider Demographics
NPI:1801245196
Name:ARWA HEALTH GROUP
Entity type:Organization
Organization Name:ARWA HEALTH GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THAR
Authorized Official - Middle Name:Y
Authorized Official - Last Name:EL BAAGE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:540-498-8877
Mailing Address - Street 1:1401 S JOYCE ST APT 1115
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22202-1882
Mailing Address - Country:US
Mailing Address - Phone:540-498-8877
Mailing Address - Fax:
Practice Address - Street 1:1401 S JOYCE ST APT 1115
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22202-1882
Practice Address - Country:US
Practice Address - Phone:540-498-8877
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-06-07
Last Update Date:2016-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME119419261QA0600X
KS0437797261QA0600X
GA061063261QC1500X
NC201502219311ZA0620X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No261QA0600XAmbulatory Health Care FacilitiesClinic/CenterAdult Day Care
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI34897500Medicaid
WI1851336341OtherMEDICAID/MEDICARE
103588Medicare UPIN