Provider Demographics
NPI:1093876195
Name:STONE BELT ARC, INC.
Entity Type:Organization
Organization Name:STONE BELT ARC, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:DEWEES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-332-2168
Mailing Address - Street 1:2815 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47408-2601
Mailing Address - Country:US
Mailing Address - Phone:812-332-2168
Mailing Address - Fax:812-323-4610
Practice Address - Street 1:4700 N HITE DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47408-9526
Practice Address - Country:US
Practice Address - Phone:812-334-0112
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-12
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities