MEDICARE: ARMS ACRES, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR0405X	Substance Use Disorder Rehabilitation Clinic/Center	100210666	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1417147273
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARMS ACRES, INC.

Provider Business Mailing Address
First Line	:	PO BOX 1841
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12201-1841
Country	:	US
Telephone Number	:	518-952-8408
Fax Number	:	518-399-6860

Provider Business Practice Location Address
First Line	:	319 BROADWAY, ROUTE 9W
Second Line	:	PORT EWEN EDUCATION CENTER, 1ST FLOOR
City	:	PORT EWEN
State	:	NY
Zip	:	12466-5501
Country	:	US
Telephone Number	:	845-339-8707
Fax Number	:	845-339-2610

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR, LIBERTY MANAGEM
Name	:	PATRICE WALLACE-MOORE
Credential	:	LCSW-R
Telephone Number	:	888-227-4641

Provider Enumeration Date	:	07/27/2007
Last Update Date	:	04/29/2021

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