Provider Demographics
NPI:1154378834
Name:THE ARC OF SOUTH NORFOLK, INC.
Entity type:Organization
Organization Name:THE ARC OF SOUTH NORFOLK, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:H
Authorized Official - Last Name:MAROT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-762-4001
Mailing Address - Street 1:789 CLAPBOARDTREE ST
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:MA
Mailing Address - Zip Code:02090-1717
Mailing Address - Country:US
Mailing Address - Phone:781-762-4001
Mailing Address - Fax:781-461-5950
Practice Address - Street 1:789 CLAPBOARDTREE ST
Practice Address - Street 2:
Practice Address - City:WESTWOOD
Practice Address - State:MA
Practice Address - Zip Code:02090-1717
Practice Address - Country:US
Practice Address - Phone:781-762-4001
Practice Address - Fax:781-461-5950
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-28
Last Update Date:2015-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4386103TM1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TM1800XBehavioral Health & Social Service ProvidersPsychologistIntellectual & Developmental DisabilitiesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1005005OtherBEACON HEALTH
MA1309471Medicaid
MA972092OtherNETWORK HEALTH
MA00000008446OtherBMC HEALTH NET PLAN
MA001353OtherHPHC - VALUE OPTIONS
MA735314OtherTUFTS HEALTH PLAN
MA1005005OtherNEIGHBORHOOD HEALTH PLAN
MAM18519OtherBLUE CROSS/BLUE SHIELD
MA735314OtherTUFTS SECURE HORIZONS
MA735314OtherTUFTS HEALTH PLAN
MA=========OtherCIGNA
MA1309471Medicaid
MA1005005OtherNEIGHBORHOOD HEALTH PLAN
MA972092OtherNETWORK HEALTH
MA735314OtherTUFTS SECURE HORIZONS
MA1309471Medicaid