=====================================================
General NPI Number Information
=====================================================
NPI Number | 1154298040
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | THE ARCH ADVOCATE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/23/2025
-----------------------------------------------------
Last Update Date | 10/23/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1043 E TERRA LN
-----------------------------------------------------
City | O FALLON
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63366-2750
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 931-434-3358
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 216 BLESS US DR E
-----------------------------------------------------
City | WENTZVILLE
-----------------------------------------------------
State | MO
-----------------------------------------------------
Zip | 63385-2227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | RALEIGH K FRYE
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 931-434-3358
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 251C00000X
-----------------------------------------------------
Taxonomy Name | Developmentally Disabled Services Day Training Agency
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------