Provider Demographics
NPI:1134433352
Name:THE ARC OF ALACHUA COUNTY, INC.
Entity type:Organization
Organization Name:THE ARC OF ALACHUA COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:J
Authorized Official - Last Name:BRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-334-4060
Mailing Address - Street 1:3303 NW 83RD ST
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32606-6227
Mailing Address - Country:US
Mailing Address - Phone:352-334-4060
Mailing Address - Fax:352-334-4059
Practice Address - Street 1:3303 NW 83RD ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:FL
Practice Address - Zip Code:32606-6227
Practice Address - Country:US
Practice Address - Phone:352-334-4060
Practice Address - Fax:352-334-4059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-29
Last Update Date:2010-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCONTRACT WITH APD251C00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL023826198Medicaid
FL023826196Medicaid