Healthcare Provider Details

I. General information

NPI: 1609256015
Provider Name (Legal Business Name): THE ARC OF MONMOUTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2015
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1427 WYCKOFF RD APT 232
WALL TOWNSHIP NJ
07727-3918
US

IV. Provider business mailing address

1158 WAYSIDE RD
TINTON FALLS NJ
07712-3148
US

V. Phone/Fax

Practice location:
  • Phone: 732-493-1919
  • Fax: 732-686-7867
Mailing address:
  • Phone: 732-493-1919
  • Fax: 732-493-3604

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code320900000X
TaxonomyIntellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
License NumberSA196
License Number StateNJ

VIII. Authorized Official

Name: ROBERT ANGEL
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 732-493-1919