Provider Demographics
NPI:1477684322
Name:THE ARC OF ST. CHARLES, INC.
Entity Type:Organization
Organization Name:THE ARC OF ST. CHARLES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRYANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:985-785-0971
Mailing Address - Street 1:13771 OLD SPANISH TRL
Mailing Address - Street 2:
Mailing Address - City:BOUTTE
Mailing Address - State:LA
Mailing Address - Zip Code:70039-3610
Mailing Address - Country:US
Mailing Address - Phone:985-785-0971
Mailing Address - Fax:985-785-0034
Practice Address - Street 1:13771 OLD SPANISH TRL
Practice Address - Street 2:
Practice Address - City:BOUTTE
Practice Address - State:LA
Practice Address - Zip Code:70039-3610
Practice Address - Country:US
Practice Address - Phone:985-785-0971
Practice Address - Fax:985-785-0034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1916170Medicaid