Provider Demographics
NPI:1003935198
Name:THE ARC OF WALKER COUNTY
Entity Type:Organization
Organization Name:THE ARC OF WALKER COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LOU
Authorized Official - Middle Name:
Authorized Official - Last Name:VICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-387-0562
Mailing Address - Street 1:745 RUSSELL DAIRY ROAD
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35503
Mailing Address - Country:US
Mailing Address - Phone:205-387-8151
Mailing Address - Fax:205-387-8210
Practice Address - Street 1:745 RUSSELL DAIRY ROAD
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35503
Practice Address - Country:US
Practice Address - Phone:205-387-8151
Practice Address - Fax:205-387-8210
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD1600XAmbulatory Health Care FacilitiesClinic/CenterDevelopmental Disabilities