Provider Demographics
NPI:1417147273
Name:ARMS ACRES, INC.
Entity Type:Organization
Organization Name:ARMS ACRES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR, LIBERTY MANAGEM
Authorized Official - Prefix:
Authorized Official - First Name:PATRICE
Authorized Official - Middle Name:
Authorized Official - Last Name:WALLACE-MOORE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:888-227-4641
Mailing Address - Street 1:PO BOX 1841
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12201-1841
Mailing Address - Country:US
Mailing Address - Phone:518-952-8408
Mailing Address - Fax:518-399-6860
Practice Address - Street 1:319 BROADWAY, ROUTE 9W
Practice Address - Street 2:PORT EWEN EDUCATION CENTER, 1ST FLOOR
Practice Address - City:PORT EWEN
Practice Address - State:NY
Practice Address - Zip Code:12466-5501
Practice Address - Country:US
Practice Address - Phone:845-339-8707
Practice Address - Fax:845-339-2610
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-27
Last Update Date:2021-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100210666261QR0405X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use Disorder
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01420795Medicaid
NYW32322Medicare PIN