Healthcare Provider Details

I. General information

NPI: 1730307539
Provider Name (Legal Business Name): THE ARC OF ST. MARTIN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 LELIA ST
SAINT MARTINVILLE LA
70582-4109
US

IV. Provider business mailing address

PO BOX 128
SAINT MARTINVILLE LA
70582-0128
US

V. Phone/Fax

Practice location:
  • Phone: 337-394-4928
  • Fax: 337-394-5974
Mailing address:
  • Phone: 337-394-4928
  • Fax: 337-394-5974

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number5239
License Number StateLA

VIII. Authorized Official

Name: MRS. CHRISTINE POCHE
Title or Position: QMRP
Credential:
Phone: 337-394-4928