Healthcare Provider Details

I. General information

NPI: 1194870378
Provider Name (Legal Business Name): THE ARC OF MOORE COUNTY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

673 S BENNETT ST
SOUTHERN PINES NC
28387-5919
US

IV. Provider business mailing address

PO BOX 773
SOUTHERN PINES NC
28388-0773
US

V. Phone/Fax

Practice location:
  • Phone: 910-692-8272
  • Fax: 910-692-4343
Mailing address:
  • Phone: 910-692-8272
  • Fax: 910-692-4343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251V00000X
TaxonomyVoluntary or Charitable Agency
License Number
License Number State

VIII. Authorized Official

Name: WENDY RUSSELL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 910-692-8272