Healthcare Provider Details

I. General information

NPI: 1063672798
Provider Name (Legal Business Name): ARC/NEPC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/16/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

316 ALDEN RD
KEARNY AZ
85237-0535
US

IV. Provider business mailing address

PO BOX 535
KEARNY AZ
85237-0535
US

V. Phone/Fax

Practice location:
  • Phone: 520-363-5581
  • Fax: 520-363-5581
Mailing address:
  • Phone: 520-363-5581
  • Fax: 520-363-5581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateAZ

VIII. Authorized Official

Name: FRANCES CHAVEZ
Title or Position: DIRECTOR
Credential:
Phone: 520-363-5581