Healthcare Provider Details

I. General information

NPI: 1487840799
Provider Name (Legal Business Name): ARMS ACRES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/20/2007
Last Update Date: 04/29/2021
Certification Date: 04/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3600 JEROME AVE
BRONX NY
10467-1052
US

IV. Provider business mailing address

PO BOX 1841
ALBANY NY
12201-1841
US

V. Phone/Fax

Practice location:
  • Phone: 718-881-7600
  • Fax: 718-654-1465
Mailing address:
  • Phone: 518-952-8408
  • Fax: 518-399-6860

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number080410665
License Number StateNY

VIII. Authorized Official

Name: PATRICE WALLACE-MOORE
Title or Position: EXECUTIVE DIRECTOR, LIBERTY MGT.
Credential: LCSW-R
Phone: 888-227-4641