Healthcare Provider Details

I. General information

NPI: 1386860211
Provider Name (Legal Business Name): ARC BRIDGES, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2270 RANBURN DR
GARY IN
46408-2456
US

IV. Provider business mailing address

2650 W 35TH AVE
GARY IN
46408-1416
US

V. Phone/Fax

Practice location:
  • Phone: 219-980-3013
  • Fax: 219-980-7315
Mailing address:
  • Phone: 219-884-1138
  • Fax: 219-980-7315

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number
License Number State

VIII. Authorized Official

Name: KRIS PROHL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 219-884-1138