MEDICARE: THE ARC OF UNION COUNTY

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	320900000X	Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility	GH809	NJ

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	:	1497139307
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE ARC OF UNION COUNTY

Provider Business Mailing Address
First Line	:	70 DIAMOND RD
Second Line	:
City	:	SPRINGFIELD
State	:	NJ
Zip	:	07081-3119
Country	:	US
Telephone Number	:	973-315-0000
Fax Number	:	973-315-0002

Provider Business Practice Location Address
First Line	:	640 PLAINFIELD AVE
Second Line	:
City	:	BERKELEY HEIGHTS
State	:	NJ
Zip	:	07922-1920
Country	:	US
Telephone Number	:	973-315-0000
Fax Number	:	973-315-0002

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MR. FRANK CARAGHER
Credential	:
Telephone Number	:	973-315-0000

Provider Enumeration Date	:	07/10/2015
Last Update Date	:	07/10/2015

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Directions to “THE ARC OF UNION COUNTY ” Practice Location

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