Provider Demographics
NPI:1851535744
Name:THE ARC EAU CLAIRE
Entity Type:Organization
Organization Name:THE ARC EAU CLAIRE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARIT
Authorized Official - Middle Name:C
Authorized Official - Last Name:WAACK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:715-514-1825
Mailing Address - Street 1:800 WISCONSIN STREET MB86
Mailing Address - Street 2:BLDG D02 SUITE 318
Mailing Address - City:EAU CLAIRE
Mailing Address - State:WI
Mailing Address - Zip Code:54703-3612
Mailing Address - Country:US
Mailing Address - Phone:715-514-1825
Mailing Address - Fax:715-514-1827
Practice Address - Street 1:800 WISCONSIN STREET MB86
Practice Address - Street 2:BLDG D02 SUITE 318
Practice Address - City:EAU CLAIRE
Practice Address - State:WI
Practice Address - Zip Code:54703-3612
Practice Address - Country:US
Practice Address - Phone:715-514-1825
Practice Address - Fax:715-514-1827
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-23
Last Update Date:2009-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251B00000XAgenciesCase Management