MEDICARE: ARC SERVICES OF MACOMB, 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	251C00000X	Developmentally Disabled Services Day Training Agency

General Provider Information

NPI Number	:	1508071226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC SERVICES OF MACOMB, INC

Provider Business Mailing Address
First Line	:	44050 N GRATIOT AVE
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48036-1308
Country	:	US
Telephone Number	:	586-469-1600
Fax Number	:	586-469-2527

Provider Business Practice Location Address
First Line	:	44050 N GRATIOT AVE
Second Line	:
City	:	CLINTON TOWNSHIP
State	:	MI
Zip	:	48036-1308
Country	:	US
Telephone Number	:	586-469-1600
Fax Number	:	586-469-2527

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	RONALD KIMBALL
Credential	:
Telephone Number	:	586-469-1600

Provider Enumeration Date	:	05/14/2007
Last Update Date	:	08/22/2020

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