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General NPI Number Information
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NPI Number | 1194935213
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Entity Type | Organization
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Legal Business Name | THE ARC OF SOUTHWEST WASHINGTON
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 05/31/2024
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Provider Practice Location Address
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Address Line | 101 E 8TH STREET STE 220
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City | VANCOUVER
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State | WA
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Zip | 98660
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Country | US
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Telephone | 360-254-1562
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Fax | 360-759-4921
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Provider Business Mailing Address
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Address Line | P.O. BOX 2608
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City | VANCOUVER
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State | WA
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Zip | 98668
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Country | US
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Telephone | 360-254-1562
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Fax | 360-759-4921
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. JEFFREY CRAIG ANGELO
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Credential |
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Telephone | 360-254-1562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 251V00000X
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Taxonomy Name | Voluntary or Charitable Agency
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License Number | 601138292
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License Number State | WA
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Taxonomy #3
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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