Provider Demographics
NPI:1992963748
Name:ARC REHAB SERVICES, INC.
Entity type:Organization
Organization Name:ARC REHAB SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:BUSINESS DIRECTOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:KAROL
Authorized Official - Middle Name:
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-482-6815
Mailing Address - Street 1:900 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:IN
Mailing Address - Zip Code:46052-2318
Mailing Address - Country:US
Mailing Address - Phone:765-482-6815
Mailing Address - Fax:765-482-6964
Practice Address - Street 1:900 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:IN
Practice Address - Zip Code:46052-2318
Practice Address - Country:US
Practice Address - Phone:765-482-6815
Practice Address - Fax:765-482-6964
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-29
Last Update Date:2008-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200714780Medicaid