MEDICARE: ARC OF THE CAPITAL AREA

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	251B00000X	Case Management Agency	0006000000	TX
2	251B00000X	Case Management Agency		TX

General Provider Information

NPI Number	:	1659490134
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC OF THE CAPITAL AREA

Provider Business Mailing Address
First Line	:	2818 SAN GABRIEL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-3597
Country	:	US
Telephone Number	:	512-476-7044
Fax Number	:	512-474-9648

Provider Business Practice Location Address
First Line	:	2818 SAN GABRIEL ST
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78705-3597
Country	:	US
Telephone Number	:	512-476-7044
Fax Number	:	512-474-9648

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. SUSAN EASON
Credential	:
Telephone Number	:	512-476-7044

Provider Enumeration Date	:	03/28/2007
Last Update Date	:	04/20/2008

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Directions to “ARC OF THE CAPITAL AREA ” Practice Location

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