Provider Demographics
NPI:1295037778
Name:THE ARC NATURE COAST INC
Entity Type:Organization
Organization Name:THE ARC NATURE COAST INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARAK
Authorized Official - Middle Name:W
Authorized Official - Last Name:BARRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-544-2322
Mailing Address - Street 1:5283 NEFF LAKE ROAD
Mailing Address - Street 2:
Mailing Address - City:BROOKSVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:34601
Mailing Address - Country:US
Mailing Address - Phone:352-544-2322
Mailing Address - Fax:352-544-2325
Practice Address - Street 1:5283 NEFF LAKE RD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34601-8018
Practice Address - Country:US
Practice Address - Phone:352-544-2322
Practice Address - Fax:352-544-2325
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-03
Last Update Date:2010-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL023831796251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023831796Medicaid
FL023831798Medicaid