Provider Demographics
NPI:1760426688
Name:THE ARC, OCEAN COUNTY CHAPTER, INC.
Entity Type:Organization
Organization Name:THE ARC, OCEAN COUNTY CHAPTER, INC.
Other - Org Name:DCF MAPLECREST GROUP HOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:FINANCE DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:SABINA
Authorized Official - Middle Name:
Authorized Official - Last Name:FINNEGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-363-3335
Mailing Address - Street 1:815 CEDAR BRIDGE AVENUE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701
Mailing Address - Country:US
Mailing Address - Phone:732-363-3335
Mailing Address - Fax:732-363-5990
Practice Address - Street 1:788 MAPLECREST RD
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08753-7850
Practice Address - Country:US
Practice Address - Phone:732-363-3335
Practice Address - Fax:732-363-2485
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-15
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ3861805Medicaid
NJ8069000Medicaid
NJ8069107Medicaid
NJ032328Medicare PIN
NJ459656NMWMedicare PIN
NJ8069107Medicaid