Organization Active NPI

Archangel Raphael Ministry Center Inc

  • Intellectual and/or Developmental Disabilities Residential Treatment Facility
  • Fort Myers, FL
National Provider Identifier
1720847726
Registry record updated Sep 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment FacilityTaxonomy code 320600000X
Legal business name
ARCHANGEL RAPHAEL MINISTRY CENTER INC
Doing business as
Archangel Raphael Ministry Center Inc
Practice address
19800 Allaire LN
Fort Myers, FL 33908-4828
Phone
(918) 704-8881
NPI assigned
Mar 13, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
FR. Joachim Boutros
Title
Trustee
Phone
(918) 704-8881

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Primary

Addresses

Primary practice location

19800 Allaire LN
Fort Myers, FL 33908-4828

Mailing address

19800 Allaire LN
Fort Myers, FL 33908-4828
Phone (918) 704-8881

Other names 1

  • ARCHANGEL RAPHAEL MINISTRY CENTER INC Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1756944000000",
    "number": "1720847726",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19800 ALLAIRE LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084828",
            "telephone_number": "918-704-8881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19800 ALLAIRE LN",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339084828",
            "telephone_number": "918-704-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHANGEL RAPHAEL MINISTRY CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-13",
        "last_updated": "2025-09-04",
        "certification_date": "2025-09-04",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "FR. JOACHIM",
        "authorized_official_title_or_position": "TRUSTEE",
        "authorized_official_telephone_number": "918-704-8881"
    },
    "taxonomies": [
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ARCHANGEL RAPHAEL MINISTRY CENTER INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Fort Myers, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.