Basic Information
| Provider Information | |||||||||
| NPI: | 1336265685 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | THE ARC OF HIGH POINT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 153 E BELLEVUE DR | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272651922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368830650 | ||||||||
| FaxNumber: | 3368830653 | ||||||||
| Practice Location | |||||||||
| Address1: | 3417 CORVAIR DR | ||||||||
| Address2: | |||||||||
| City: | HIGH POINT | ||||||||
| State: | NC | ||||||||
| PostalCode: | 272651809 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3368830650 | ||||||||
| FaxNumber: | 3368830653 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2007 | ||||||||
| LastUpdateDate: | 06/25/2008 | ||||||||
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| AuthorizedOfficialLastName: | MCCANN | ||||||||
| AuthorizedOfficialFirstName: | KARA | ||||||||
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| AuthorizedOfficialTitleorPosition: | DIRECTOR OF PROGRAM SUPPORTS | ||||||||
| AuthorizedOfficialTelephone: | 3368830650 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 320900000X | MHL-041-564 | NC | Y | Residential Treatment Facilities | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
ID Information
| ID | Type | State | Issuer | Description | 7805250 | 05 | NC | MEDICAID |