Provider Demographics
NPI:1083166128
Name:THE ARC OF MONMOUTH
Entity Type:Organization
Organization Name:THE ARC OF MONMOUTH
Other - Org Name:SHORE ACHIEVEMENT CENTER
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:ANGEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-493-1919
Mailing Address - Street 1:1158 WAYSIDE RD
Mailing Address - Street 2:
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-3148
Mailing Address - Country:US
Mailing Address - Phone:732-493-1919
Mailing Address - Fax:732-493-3604
Practice Address - Street 1:1345 CAMPUS PKWY STE A9
Practice Address - Street 2:
Practice Address - City:WALL TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:07753-6828
Practice Address - Country:US
Practice Address - Phone:732-493-1919
Practice Address - Fax:732-493-3604
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ARC OF MONMOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-10-25
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services