Healthcare Provider Details

I. General information

NPI: 1952927717
Provider Name (Legal Business Name): ARC DAYTON
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2020
Last Update Date: 01/08/2021
Certification Date: 01/08/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2009 E DAYTON ST
MADISON WI
53704-4720
US

IV. Provider business mailing address

2001 W BELTLINE HWY STE 102
MADISON WI
53713-2366
US

V. Phone/Fax

Practice location:
  • Phone: 608-241-7616
  • Fax:
Mailing address:
  • Phone: 608-278-2300
  • Fax: 608-278-2313

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: ROBIN RYAN
Title or Position: CHIEF OPERATING OFFICER
Credential:
Phone: 608-278-2300