Provider Demographics
NPI:1497137442
Name:THE ARC OF BURLINGTON COUNTY
Entity Type:Organization
Organization Name:THE ARC OF BURLINGTON COUNTY
Other - Org Name:THE ARC OF BURLINGTON COUNTY - SELF DIRECTED SUPPORT
Other - Org Type:Other Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NEVADOMSKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-531-0211
Mailing Address - Street 1:115 E BROAD ST
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08016-1515
Mailing Address - Country:US
Mailing Address - Phone:609-531-0211
Mailing Address - Fax:
Practice Address - Street 1:695A MAIN ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NJ
Practice Address - Zip Code:08048-5013
Practice Address - Country:US
Practice Address - Phone:609-702-5835
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-26
Last Update Date:2021-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251C00000XAgenciesDay Training, Developmentally Disabled Services