Healthcare Provider Details

I. General information

NPI: 1861874679
Provider Name (Legal Business Name): THE ARC OF UNION COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2015
Last Update Date: 06/29/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 THORNTON AVE
PLAINFIELD NJ
07060-2638
US

IV. Provider business mailing address

70 DIAMOND RD
SPRINGFIELD NJ
07081-3119
US

V. Phone/Fax

Practice location:
  • Phone: 973-315-0000
  • Fax: 973-315-0002
Mailing address:
  • Phone: 973-315-0000
  • Fax: 973-315-0002

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberGH547
License Number StateNJ

VII. Legacy identifiers

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

# 1
IdentifierGH547
Identifier TypeMEDICAID
Identifier StateNJ
Identifier Issuer

VIII. Authorized Official

Name: MR. FRANK CARAGHER
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 973-315-0000