Healthcare Provider Details

I. General information

NPI: 1023672516
Provider Name (Legal Business Name): ARCA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2019
Last Update Date: 12/23/2019
Certification Date: 12/23/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1503 4TH ST NW
ALBUQUERQUE NM
87102-1420
US

IV. Provider business mailing address

11200 LOMAS BLVD NE
ALBUQUERQUE NM
87112-5514
US

V. Phone/Fax

Practice location:
  • Phone: 505-274-4442
  • Fax:
Mailing address:
  • Phone: 505-332-6832
  • Fax: 505-332-6719

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MR. JOSEPH FRANCIS ALMOND
Title or Position: ACCOUNTING MANAGER
Credential: DELEGATED OFFICIAL
Phone: 505-332-6832