Provider Demographics
NPI:1326347626
Name:ARC THERAPY SERVICES LLC
Entity Type:Organization
Organization Name:ARC THERAPY SERVICES LLC
Other - Org Name:BROOKDALE HOME HEALTH VALPARAISO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER, REGULATORY PRACTICES
Authorized Official - Prefix:
Authorized Official - First Name:DONNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:EVANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:615-564-8181
Mailing Address - Street 1:111 WESTWOOD PLACE
Mailing Address - Street 2:STE 400
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-5057
Mailing Address - Country:US
Mailing Address - Phone:615-221-2250
Mailing Address - Fax:
Practice Address - Street 1:3444 SWANSON RD
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-4999
Practice Address - Country:US
Practice Address - Phone:219-762-7917
Practice Address - Fax:219-764-2194
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-25
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN16-012551-1251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
157642Medicare Oscar/Certification