MEDICARE: ARC BOCA RATON, INC.

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	310400000X	Assisted Living Facility

General Provider Information

NPI Number	:	1295034734
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARC BOCA RATON, INC.

Provider Business Mailing Address
First Line	:	6737 W WASHINGTON ST
Second Line	:	SUITE 2300
City	:	MILWAUKEE
State	:	WI
Zip	:	53214-5647
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	9591 YAMATO RD
Second Line	:
City	:	BOCA RATON
State	:	FL
Zip	:	33434-5549
Country	:	US
Telephone Number	:	561-477-1665
Fax Number	:

Authorized Official
Title or Position	:	CO-PRESIDENT
Name	:	MARK OHLENDORF
Credential	:
Telephone Number	:	414-918-5000

Provider Enumeration Date	:	03/23/2011
Last Update Date	:	03/23/2011

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Directions to “ARC BOCA RATON, INC. ” Practice Location

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