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Organization
CITIZENS SENIOR LIVING INC
Active
Organization
CITIZENS SENIOR LIVING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL ARCHIBONG JACK CEO (CEO/ADMINISTRATOR)
(919) 633-9397
Entity
Organization
Contact information
Practice address
5540 CENTERVIEW DR STE 200, RALEIGH, NC 27606-3386
(919) 276-4602
Mailing address
4012 BURLINGTON MILLS RD APT 2B, WAKE FOREST, NC 27587-9103
(919) 633-9397
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
106H00000X
Marriage & Family Therapist
—
—
224Z00000X
Occupational Therapy Assistant
—
—
251E00000X
Home Health Agency
Primary
—
—
251F00000X
Home Infusion Agency
—
—
251G00000X
Community Based Hospice Care Agency
—
—
251J00000X
Nursing Care Agency
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
—
261QP2000X
Physical Therapy Clinic/Center
—
—
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
—
—
283X00000X
Rehabilitation Hospital
—
—
3104A0625X
Assisted Living Facility (Mental Illness)
—
—
3140N1450X
Pediatric Skilled Nursing Facility
—
—
332BX2000X
Oxygen Equipment & Supplies (DME)
—
—
Other
Enumeration date
07/25/2019
Last updated
03/06/2020
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