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General NPI Number Information
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NPI Number | 1295037778
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Entity Type | Organization
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Legal Business Name | THE ARC NATURE COAST INC
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Dates
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Enumeration Date | 12/03/2010
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Last Update Date | 12/03/2010
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Provider Practice Location Address
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Address Line | 5283 NEFF LAKE RD
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City | BROOKSVILLE
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State | FL
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Zip | 34601-8018
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Country | US
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Telephone | 352-544-2322
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Fax | 352-544-2325
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Provider Business Mailing Address
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Address Line | 5283 NEFF LAKE ROAD
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City | BROOKSVILLE
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State | FL
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Zip | 34601
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Country | US
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Telephone | 352-544-2322
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Fax | 352-544-2325
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. MARAK W BARRY
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Credential |
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Telephone | 352-544-2322
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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 | 023831796
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License Number State | FL
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