MEDICARE: THE ARC OCEAN COUNTY CHAPTER, 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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility

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	:	1811377310
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ARC OCEAN COUNTY CHAPTER, INC.

Provider Business Mailing Address
First Line	:	815 CEDAR BRIDGE AVE
Second Line	:
City	:	LAKEWOOD
State	:	NJ
Zip	:	08701-4932
Country	:	US
Telephone Number	:	732-363-3335
Fax Number	:	732-363-2485

Provider Business Practice Location Address
First Line	:	19 NEWPORT CT
Second Line	:
City	:	BRICK
State	:	NJ
Zip	:	08724-2039
Country	:	US
Telephone Number	:	732-363-3335
Fax Number	:	732-363-2485

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	LAURA WILLIAMS
Credential	:
Telephone Number	:	732-363-3335

Provider Enumeration Date	:	06/01/2015
Last Update Date	:	08/18/2015

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