Provider Demographics
NPI:1750509550
Name:THE ARC OF ST. MARTIN, INC.
Entity Type:Organization
Organization Name:THE ARC OF ST. MARTIN, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:QMRP
Authorized Official - Prefix:MRS
Authorized Official - First Name:CHRISTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:POCHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:337-394-4928
Mailing Address - Street 1:PO BOX 128
Mailing Address - Street 2:
Mailing Address - City:SAINT MARTINVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70582-0128
Mailing Address - Country:US
Mailing Address - Phone:337-394-4928
Mailing Address - Fax:337-394-5974
Practice Address - Street 1:500 LELIA ST
Practice Address - Street 2:
Practice Address - City:SAINT MARTINVILLE
Practice Address - State:LA
Practice Address - Zip Code:70582-4109
Practice Address - Country:US
Practice Address - Phone:337-394-4928
Practice Address - Fax:337-394-5974
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA5239251C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1935182Medicaid