Healthcare Provider Details

I. General information

NPI: 1154579662
Provider Name (Legal Business Name): ARC THERAPY SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 04/25/2022
Certification Date: 04/25/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4012 COMMONS DRIVE SUITE 224-C
DESTIN FL
32541-8422
US

IV. Provider business mailing address

1 PARK PLZ
NASHVILLE TN
37203-6527
US

V. Phone/Fax

Practice location:
  • Phone: 850-650-2326
  • Fax:
Mailing address:
  • Phone: 615-344-9551
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number299993615
License Number StateFL

VIII. Authorized Official

Name: DONNIS M. EVANS
Title or Position: MANAGER, REGULATORY PRACTICES
Credential:
Phone: 615-278-0367