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General NPI Number Information
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NPI Number | 1851388185
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Entity Type | Organization
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Legal Business Name | THE ARC OF ST. LUCIE COUNTY, INC.
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Dates
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Enumeration Date | 10/03/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 705 KITTERMAN RD
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City | FORT PIERCE
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State | FL
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Zip | 34952-9018
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Country | US
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Telephone | 772-466-7957
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Fax | 772-466-7957
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Provider Business Mailing Address
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Address Line | PO BOX 1016
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City | FORT PIERCE
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State | FL
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Zip | 34954-1016
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Country | US
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Telephone | 772-468-7879
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Fax | 772-465-7050
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | CHERYL L. KING
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Credential |
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Telephone | 772-468-7879
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320800000X
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Taxonomy Name | Mental Illness Community Based Residential Treatment Facility
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License Number | 8587
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License Number State | FL
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