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General NPI Number Information
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NPI Number | 1902398589
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Entity Type | Organization
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Legal Business Name | THE ARC OF SAN DIEGO
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Dates
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Enumeration Date | 05/31/2018
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Last Update Date | 05/31/2018
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Provider Practice Location Address
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Address Line | 1280 NOLAN AVENUE
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City | CHULA VISTA
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State | CA
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Zip | 91911
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Country | US
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Telephone | 619-427-7524
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Fax |
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Provider Business Mailing Address
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Address Line | 3030 MARKET STREET
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City | SAN DIEGO
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State | CA
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Zip | 92102
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Country | US
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Telephone | 619-685-1175
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Fax |
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Authorized Official
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Title or Position | PRESIDENT & CEO
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Name | ANTHONY DESALIS
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Credential | ESQ
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Telephone | 619-685-1175
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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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