Provider Demographics
NPI:1750745899
Name:ARC OF MAUI COUNTY
Entity type:Organization
Organization Name:ARC OF MAUI COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:SEGUNDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-242-5781
Mailing Address - Street 1:95 MAHALANI ST
Mailing Address - Street 2:SUITE 17
Mailing Address - City:WAILUKU
Mailing Address - State:HI
Mailing Address - Zip Code:96793-2521
Mailing Address - Country:US
Mailing Address - Phone:808-242-5781
Mailing Address - Fax:808-244-4061
Practice Address - Street 1:95 MAHALANI ST
Practice Address - Street 2:SUITE 17
Practice Address - City:WAILUKU
Practice Address - State:HI
Practice Address - Zip Code:96793-2521
Practice Address - Country:US
Practice Address - Phone:808-242-5781
Practice Address - Fax:808-244-4061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-05
Last Update Date:2016-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI508286Medicaid