Provider Demographics
NPI:1659490134
Name:ARC OF THE CAPITAL AREA
Entity Type:Organization
Organization Name:ARC OF THE CAPITAL AREA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SUSAN
Authorized Official - Middle Name:
Authorized Official - Last Name:EASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-476-7044
Mailing Address - Street 1:2818 SAN GABRIEL ST
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705-3597
Mailing Address - Country:US
Mailing Address - Phone:512-476-7044
Mailing Address - Fax:512-474-9648
Practice Address - Street 1:2818 SAN GABRIEL ST
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705-3597
Practice Address - Country:US
Practice Address - Phone:512-476-7044
Practice Address - Fax:512-474-9648
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-28
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0006000000251B00000X
TX251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1=========001OtherTEXAS COMPTROLLER I.D.