Provider Demographics
NPI:1679072318
Name:THE ARC OF HUNTERDON COUNTY
Entity type:Organization
Organization Name:THE ARC OF HUNTERDON COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAID BILLER
Authorized Official - Prefix:
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DIALFONSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-730-7827
Mailing Address - Street 1:1465 ROUTE 31 S STE 23
Mailing Address - Street 2:
Mailing Address - City:ANNANDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:08801-3131
Mailing Address - Country:US
Mailing Address - Phone:908-730-7827
Mailing Address - Fax:908-333-4129
Practice Address - Street 1:968 RTE 202 S
Practice Address - Street 2:
Practice Address - City:BRANCHBURG
Practice Address - State:NJ
Practice Address - Zip Code:08876-3732
Practice Address - Country:US
Practice Address - Phone:908-730-7827
Practice Address - Fax:908-333-4129
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJGH1406320900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0478059Medicaid