Provider Demographics
NPI:1194870378
Name:THE ARC OF MOORE COUNTY INC.
Entity type:Organization
Organization Name:THE ARC OF MOORE COUNTY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:RUSSELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-692-8272
Mailing Address - Street 1:PO BOX 773
Mailing Address - Street 2:
Mailing Address - City:SOUTHERN PINES
Mailing Address - State:NC
Mailing Address - Zip Code:28388-0773
Mailing Address - Country:US
Mailing Address - Phone:910-692-8272
Mailing Address - Fax:910-692-4343
Practice Address - Street 1:673 S BENNETT ST
Practice Address - Street 2:
Practice Address - City:SOUTHERN PINES
Practice Address - State:NC
Practice Address - Zip Code:28387-5919
Practice Address - Country:US
Practice Address - Phone:910-692-8272
Practice Address - Fax:910-692-4343
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251V00000XAgenciesVoluntary or Charitable
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC3408286Medicaid