Organization
JOHN ARCHER LLC
Active
Other names
River Basin Foster Home
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RAYMOND ARCHER (CEO)
(715) 205-1449
Entity
Organization
Contact information
Practice address
2013 RIVER BASIN TER, PUNTA GORDA, FL 33982-1106
(715) 205-1449
Mailing address
2013 RIVER BASIN TER, PUNTA GORDA, FL 33982-1106
(715) 205-1449
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102889500
—
FL
Enumeration date
10/09/2019
Last updated
10/09/2019
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