Provider Demographics
NPI:1972021103
Name:THE ARC, WARREN COUNTY CHAPTER
Entity Type:Organization
Organization Name:THE ARC, WARREN COUNTY CHAPTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:ALEXANDER
Authorized Official - Last Name:PRUZNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-689-7525
Mailing Address - Street 1:319 W WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07882-2157
Mailing Address - Country:US
Mailing Address - Phone:908-689-7525
Mailing Address - Fax:908-689-4898
Practice Address - Street 1:34 BUSH ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:NJ
Practice Address - Zip Code:07863-3002
Practice Address - Country:US
Practice Address - Phone:908-453-3019
Practice Address - Fax:908-453-3159
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-08
Last Update Date:2017-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJGH604320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities