Provider Demographics
NPI:1528182821
Name:THE ARC OF THE PIEDMONT, INC.
Entity Type:Organization
Organization Name:THE ARC OF THE PIEDMONT, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FINANCE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:BOOTH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:434-977-4002
Mailing Address - Street 1:509 PARK ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-4739
Mailing Address - Country:US
Mailing Address - Phone:434-977-4002
Mailing Address - Fax:
Practice Address - Street 1:509 PARK ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4739
Practice Address - Country:US
Practice Address - Phone:434-977-4002
Practice Address - Fax:434-977-7864
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA235500000X, 320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered235500000XSpeech, Language and Hearing Service ProvidersSpecialist/TechnologistGroup - Single Specialty
Not Answered320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities