MEDICARE: ARCA - LOUISIANA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	315P00000X	Intellectual Disabilities Intermediate Care Facility	5022	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134264971
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARCA - LOUISIANA

Provider Business Mailing Address
First Line	:	11300 LOMAS BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87112-5512
Country	:	US
Telephone Number	:	505-332-6814
Fax Number	:	505-332-6800

Provider Business Practice Location Address
First Line	:	615 LOUISIANA BLVD SE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-3844
Country	:	US
Telephone Number	:	505-332-6814
Fax Number	:	505-332-6800

Authorized Official
Title or Position	:	DIRECTOR
Name	:	VINCE SMITH
Credential	:
Telephone Number	:	505-332-6814

Provider Enumeration Date	:	02/20/2007
Last Update Date	:	06/04/2021

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Directions to “ARCA - LOUISIANA ” Practice Location

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