Provider Demographics
NPI:1154505501
Name:ARC OF MARTIN COUNTY, INC.
Entity Type:Organization
Organization Name:ARC OF MARTIN COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:W
Authorized Official - Last Name:MUNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:772-283-2525
Mailing Address - Street 1:2001 S KANNER HWY
Mailing Address - Street 2:
Mailing Address - City:STUART
Mailing Address - State:FL
Mailing Address - Zip Code:34994-4609
Mailing Address - Country:US
Mailing Address - Phone:772-283-2525
Mailing Address - Fax:772-286-6808
Practice Address - Street 1:2001 S KANNER HWY
Practice Address - Street 2:
Practice Address - City:STUART
Practice Address - State:FL
Practice Address - Zip Code:34994-4609
Practice Address - Country:US
Practice Address - Phone:772-283-2525
Practice Address - Fax:772-286-6808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-20
Last Update Date:2007-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL670556196Medicaid
FL670556198Medicaid