Provider Demographics
NPI:1619357134
Name:THE ARC OF MONMOUTH
Entity Type:Organization
Organization Name:THE ARC OF MONMOUTH
Other - Org Name:BERGERVILLE GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BILLING SPECIALIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMAR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-493-1919
Mailing Address - Street 1:122 BERGERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-8518
Mailing Address - Country:US
Mailing Address - Phone:732-462-0720
Mailing Address - Fax:732-462-9694
Practice Address - Street 1:122 BERGERVILLE RD
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-8518
Practice Address - Country:US
Practice Address - Phone:732-462-0720
Practice Address - Fax:732-462-9694
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:THE ARC OF MONMOUTH
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-06-01
Last Update Date:2022-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities