Provider Demographics
NPI:1730476029
Name:THE ARC OF BRISTOL COUNTY, INC
Entity Type:Organization
Organization Name:THE ARC OF BRISTOL COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDRADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-226-1445
Mailing Address - Street 1:141 PARK ST
Mailing Address - Street 2:
Mailing Address - City:ATTLEBORO
Mailing Address - State:MA
Mailing Address - Zip Code:02703-3020
Mailing Address - Country:US
Mailing Address - Phone:508-226-1445
Mailing Address - Fax:508-226-1476
Practice Address - Street 1:333 GEORGE WASHINGTON HWY
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1948
Practice Address - Country:US
Practice Address - Phone:401-233-1634
Practice Address - Fax:401-233-1674
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-07-07
Last Update Date:2011-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI395251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
RITA56213OtherSTATE OF RHODE ISLAND MEDICAL ASSISTANCE PROVIDER NUMBER