Provider Demographics
NPI:1215004940
Name:THE ARC OF SHELBY COUNTY, INC.
Entity type:Organization
Organization Name:THE ARC OF SHELBY COUNTY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:H
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-664-9313
Mailing Address - Street 1:203 AMPHITHEATER RD
Mailing Address - Street 2:SUITE H
Mailing Address - City:PELHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35124-4302
Mailing Address - Country:US
Mailing Address - Phone:205-664-9313
Mailing Address - Fax:205-664-1934
Practice Address - Street 1:203 AMPHITHEATER RD
Practice Address - Street 2:
Practice Address - City:PELHAM
Practice Address - State:AL
Practice Address - Zip Code:35124-4302
Practice Address - Country:US
Practice Address - Phone:205-664-9313
Practice Address - Fax:205-664-1934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2013-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL251C00000X, 252Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
No251C00000XAgenciesDay Training, Developmentally Disabled Services
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL591600054Medicaid