Provider Demographics
NPI:1821214750
Name:ARC BRIDGES, INC
Entity Type:Organization
Organization Name:ARC BRIDGES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PROHL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-884-1138
Mailing Address - Street 1:2650 W 35TH AVE
Mailing Address - Street 2:
Mailing Address - City:GARY
Mailing Address - State:IN
Mailing Address - Zip Code:46408-1416
Mailing Address - Country:US
Mailing Address - Phone:219-884-1138
Mailing Address - Fax:219-980-7315
Practice Address - Street 1:3117 WOODBINE ST
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:IN
Practice Address - Zip Code:46368-4541
Practice Address - Country:US
Practice Address - Phone:219-762-7308
Practice Address - Fax:219-980-7315
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home