Provider Demographics
NPI:1689040396
Name:ASSOC. FOR RETARDED CITIZENS, INC. GLOUCESTER COUNTY
Entity Type:Organization
Organization Name:ASSOC. FOR RETARDED CITIZENS, INC. GLOUCESTER COUNTY
Other - Org Name:THE ARC GLOUCESTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RIVERA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:856-848-8648
Mailing Address - Street 1:1555 GATEWAY BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:WEST DEPTFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:08096
Mailing Address - Country:US
Mailing Address - Phone:856-848-8648
Mailing Address - Fax:856-848-7753
Practice Address - Street 1:1200 NORTH DELSEA DRIVE
Practice Address - Street 2:SUPPORTED EMPLOYMENT
Practice Address - City:WESTVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08093
Practice Address - Country:US
Practice Address - Phone:856-848-5810
Practice Address - Fax:856-848-4870
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-08-17
Last Update Date:2015-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health