Provider Demographics
NPI:1386992501
Name:ARCH WAY HOUSING PROGRAM, INC.
Entity type:Organization
Organization Name:ARCH WAY HOUSING PROGRAM, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:L
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:MA
Authorized Official - Phone:404-326-9898
Mailing Address - Street 1:2402 OWENS LANDING WAY NW
Mailing Address - Street 2:
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30152-6551
Mailing Address - Country:US
Mailing Address - Phone:404-326-9898
Mailing Address - Fax:770-529-2679
Practice Address - Street 1:2402 OWENS LANDING WAY NW
Practice Address - Street 2:
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30152-6551
Practice Address - Country:US
Practice Address - Phone:404-326-9898
Practice Address - Fax:770-529-2679
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARCH WAY HOUSING PROGRAM, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-08-20
Last Update Date:2012-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)