Provider Demographics
NPI:1679652200
Name:THE ARC OF SOUTHWEST GEORGIA
Entity Type:Organization
Organization Name:THE ARC OF SOUTHWEST GEORGIA
Other - Org Name:ALBANY ADVOCACY RESOURCE CENTER, INC
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DEANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:JULIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:229-888-6852
Mailing Address - Street 1:PO BOX 71026
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31708-1026
Mailing Address - Country:US
Mailing Address - Phone:229-888-6852
Mailing Address - Fax:229-888-6875
Practice Address - Street 1:2200 STUART AVE
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-1729
Practice Address - Country:US
Practice Address - Phone:229-888-6852
Practice Address - Fax:229-888-6875
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047R0008251B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000530307AMedicaid
GA085502538GMedicaid
GA000653375AMedicaid