Provider Demographics
NPI:1215515341
Name:THE ARC OF THE CENTRAL CHESAPEAKE REGION, INC.
Entity type:Organization
Organization Name:THE ARC OF THE CENTRAL CHESAPEAKE REGION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT & CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHON
Authorized Official - Middle Name:
Authorized Official - Last Name:RONDEAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:410-384-4035
Mailing Address - Street 1:999 CORPORATE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:LINTHICUM
Mailing Address - State:MD
Mailing Address - Zip Code:21090-2271
Mailing Address - Country:US
Mailing Address - Phone:410-269-1883
Mailing Address - Fax:
Practice Address - Street 1:999 CORPORATE BLVD STE 300
Practice Address - Street 2:
Practice Address - City:LINTHICUM
Practice Address - State:MD
Practice Address - Zip Code:21090-2271
Practice Address - Country:US
Practice Address - Phone:410-269-1883
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-30
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD156442100Medicaid