Basic Information
Provider Information
NPI: 1801172127
EntityType: 2
ReplacementNPI:  
OrganizationName: ARC THERAPY SERVICES LLC
LastName:  
FirstName:  
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName: BROOKDALE HOSPICE AUSTIN
OtherOrganizationType: 3
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 111 WESTWOOD PL
Address2:  
City: BRENTWOOD
State: TN
PostalCode: 370275021
CountryCode: US
TelephoneNumber: 6152212250
FaxNumber: 6152212280
Practice Location
Address1: 3636 EXECUTIVE CENTER DR
Address2: BLD 8, STE 210
City: AUSTIN
State: TX
PostalCode: 787311643
CountryCode: US
TelephoneNumber: 5127950204
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/01/2011
LastUpdateDate: 05/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode:  
AuthorizedOfficialLastName: EVANS
AuthorizedOfficialFirstName: DONNIS
AuthorizedOfficialMiddleName: M.
AuthorizedOfficialTitleorPosition: MANAGER, REGULATORY PRACTICES
AuthorizedOfficialTelephone: 6155648181
IsSoleProprietor:  
IsOrganizationSubpart: N
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
251G00000X  Y AgenciesHospice Care, Community Based 

No ID Information.


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