Provider Demographics
NPI:1578131728
Name:ARC REHAB SERVICES LLC
Entity Type:Organization
Organization Name:ARC REHAB SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:DANILO
Authorized Official - Middle Name:FAJARDO
Authorized Official - Last Name:IGNACIO
Authorized Official - Suffix:JR
Authorized Official - Credentials:PT
Authorized Official - Phone:315-887-0221
Mailing Address - Street 1:2 DEBBIE LN
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-6759
Mailing Address - Country:US
Mailing Address - Phone:315-887-0221
Mailing Address - Fax:
Practice Address - Street 1:2 DEBBIE LN
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6759
Practice Address - Country:US
Practice Address - Phone:315-887-0221
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-06-15
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty