Healthcare Provider Details

I. General information

NPI: 1861867269
Provider Name (Legal Business Name): THE ARC OF BERGEN AND PASSAIC COUNTIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2015
Last Update Date: 12/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 MOORE ST
HACKENSACK NJ
07601-7402
US

IV. Provider business mailing address

223 MOORE ST
HACKENSACK NJ
07601-7402
US

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code385HR2060X
TaxonomyChild Intellectual and/or Developmental Disabilities Respite Care
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KATHY WALSH
Title or Position: PRESIDENT/CEO
Credential:
Phone: 201-343-0322