Healthcare Provider Details

I. General information

NPI: 1497314017
Provider Name (Legal Business Name): THE ARC OF CLARKE COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2019
Last Update Date: 06/07/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 FOREST AVE
JACKSON AL
36545-3623
US

IV. Provider business mailing address

PO BOX 100
JACKSON AL
36545-0100
US

V. Phone/Fax

Practice location:
  • Phone: 251-246-3000
  • Fax: 251-246-3098
Mailing address:
  • Phone: 251-246-3000
  • Fax: 251-246-3098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code320600000X
TaxonomyIntellectual and/or Developmental Disabilities Residential Treatment Facility
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License Number
License Number State

VIII. Authorized Official

Name: KIMBERLY W. NELSON
Title or Position: OPERATIONS DIRECTOR
Credential:
Phone: 251-246-3000