Provider Demographics
NPI:1700928629
Name:ARCH, INC
Entity Type:Organization
Organization Name:ARCH, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:BETTY
Authorized Official - Middle Name:J
Authorized Official - Last Name:KETELSEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:563-243-9035
Mailing Address - Street 1:PO BOX 278
Mailing Address - Street 2:715 SOUTH 3RD STREET
Mailing Address - City:CLINTON
Mailing Address - State:IA
Mailing Address - Zip Code:52733-0278
Mailing Address - Country:US
Mailing Address - Phone:563-243-9035
Mailing Address - Fax:563-243-7796
Practice Address - Street 1:715 S 3RD ST
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:IA
Practice Address - Zip Code:52732-4312
Practice Address - Country:US
Practice Address - Phone:563-243-9035
Practice Address - Fax:563-243-7796
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes315P00000XNursing & Custodial Care FacilitiesIntermediate Care Facility, Intellectual Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0890871Medicaid
IA0892711Medicaid
IA0460246Medicaid
IA0896084Medicaid