Provider Demographics
NPI:1417475401
Name:ARC OF CAMDEN COUNTY HAYES MILL SUPPORTED LIVING
Entity Type:Organization
Organization Name:ARC OF CAMDEN COUNTY HAYES MILL SUPPORTED LIVING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:MANNION
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-767-3807
Mailing Address - Street 1:215 W WHITE HORSE PIKE
Mailing Address - Street 2:
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-1132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:187 HAYES MILL RD APT 21
Practice Address - Street 2:
Practice Address - City:ATCO
Practice Address - State:NJ
Practice Address - Zip Code:08004-2250
Practice Address - Country:US
Practice Address - Phone:856-767-3807
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARC OF CAMDEN COUNTY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-08-30
Last Update Date:2017-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities