Healthcare Provider Details

I. General information

NPI: 1548632102
Provider Name (Legal Business Name): THE ARC OF BERGENA AND PASSAIC COUNTIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2015
Last Update Date: 06/14/2022
Certification Date: 06/08/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

340 OUTWATER LN
GARFIELD NJ
07026-2586
US

IV. Provider business mailing address

223 MOORE ST
HACKENSACK NJ
07601-7402
US

V. Phone/Fax

Practice location:
  • Phone: 201-825-4888
  • Fax:
Mailing address:
  • Phone: 201-343-0322
  • Fax: 201-343-0401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code385HR2050X
TaxonomyRespite Care Camp
License Number
License Number State

VIII. Authorized Official

Name: MS. KATHY WALSH
Title or Position: CONTROLLER
Credential:
Phone: 201-343-0322