Provider Demographics
NPI:1619356185
Name:THE ARC OCEAN COUNTY CHAPTER, INC.
Entity Type:Organization
Organization Name:THE ARC OCEAN COUNTY CHAPTER, INC.
Other - Org Name:PIER AVENUE GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-3335
Mailing Address - Street 1:815 CEDAR BRIDGE 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:732-363-3335
Mailing Address - Fax:732-363-2485
Practice Address - Street 1:143 PIER AVE
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-3455
Practice Address - Country:US
Practice Address - Phone:732-363-3335
Practice Address - Fax:732-363-2485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-29
Last Update Date:2015-08-18
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