Provider Demographics
NPI:1346808409
Name:ARC RESIDENTIAL CARE
Entity Type:Organization
Organization Name:ARC RESIDENTIAL CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:JILL
Authorized Official - Middle Name:
Authorized Official - Last Name:CASSIANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:920-832-8032
Mailing Address - Street 1:PO BOX 193
Mailing Address - Street 2:
Mailing Address - City:CLINTONVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54929-0193
Mailing Address - Country:US
Mailing Address - Phone:920-832-8032
Mailing Address - Fax:920-832-3832
Practice Address - Street 1:N10777 HILL TOP RD
Practice Address - Street 2:
Practice Address - City:CLINTONVILLE
Practice Address - State:WI
Practice Address - Zip Code:54929-9078
Practice Address - Country:US
Practice Address - Phone:920-832-8032
Practice Address - Fax:920-832-3832
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-04
Last Update Date:2019-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care