Provider Demographics
NPI:1528584497
Name:THE ARC OCEAN COUNTY CHAPTER, INC.
Entity Type:Organization
Organization Name:THE ARC OCEAN COUNTY CHAPTER, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:STONEHAM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-3335
Mailing Address - Street 1:815 CEDARBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4932
Mailing Address - Country:US
Mailing Address - Phone:732-363-6333
Mailing Address - Fax:
Practice Address - Street 1:2257 MASSACHUSETTS AVE. APT 126
Practice Address - Street 2:MEADOW GREEN AT TOMS RIVER APT 126
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755
Practice Address - Country:US
Practice Address - Phone:732-363-3335
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2017-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0463027Medicaid