Provider Demographics
NPI:1821613209
Name:ARC PERSONAL CARE SERVICES AND TRANSPORTATION LLC
Entity Type:Organization
Organization Name:ARC PERSONAL CARE SERVICES AND TRANSPORTATION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUDRY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENTS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-523-0259
Mailing Address - Street 1:2144 MARKET GARDEN LN
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40509-8524
Mailing Address - Country:US
Mailing Address - Phone:185-952-3025
Mailing Address - Fax:
Practice Address - Street 1:2144 MARKET GARDEN LN
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40509-8524
Practice Address - Country:US
Practice Address - Phone:859-523-0259
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-11
Last Update Date:2020-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100589220OtherTRANSPORTATION
KY7100589220Medicaid