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General NPI Number Information
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NPI Number | 1497314017
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Entity Type | Organization
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Legal Business Name | THE ARC OF CLARKE COUNTY, INC.
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Dates
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Enumeration Date | 06/07/2019
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Last Update Date | 06/07/2019
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Provider Practice Location Address
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Address Line | 501 FOREST AVE
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City | JACKSON
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State | AL
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Zip | 36545-3623
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Country | US
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Telephone | 251-246-3000
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Fax | 251-246-3098
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | JACKSON
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State | AL
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Zip | 36545-0100
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Country | US
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Telephone | 251-246-3000
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Fax | 251-246-3098
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Authorized Official
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Title or Position | OPERATIONS DIRECTOR
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Name | KIMBERLY W. NELSON
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Credential |
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Telephone | 251-246-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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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 | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State |
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Taxonomy #3
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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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