Provider Demographics
NPI:1679915540
Name:ARC OF SHELBY COUNTY
Entity Type:Organization
Organization Name:ARC OF SHELBY COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:ANGELA
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-664-9313
Mailing Address - Street 1:203 AMPHITHEATER RD
Mailing Address - Street 2:
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4302
Mailing Address - Country:US
Mailing Address - Phone:205-664-9313
Mailing Address - Fax:205-664-1934
Practice Address - Street 1:203 AMPHITHEATER RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4302
Practice Address - Country:US
Practice Address - Phone:205-664-9313
Practice Address - Fax:205-664-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2186252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency