Healthcare Provider Details
I. General information
NPI: 1154451581
Provider Name (Legal Business Name): THE ARC OF PALM BEACH COUNTY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/06/2007
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1201 AUSTRALIAN AVE
RIVIERA BEACH FL
33404-6635
US
IV. Provider business mailing address
1201 AUSTRALIAN AVE
RIVIERA BEACH FL
33404-6635
US
V. Phone/Fax
- Phone: 561-842-3213
- Fax: 561-863-4352
- Phone: 561-842-3213
- Fax: 561-863-4352
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251S00000X |
| Taxonomy | Community/Behavioral Health Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251V00000X |
| Taxonomy | Voluntary or Charitable Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RUSSELL
J.
GREENE
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 561-842-3213