Provider Demographics
NPI:1588310262
Name:THE ARC OF LEVY COUNTY, INC
Entity type:Organization
Organization Name:THE ARC OF LEVY COUNTY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:DANIELS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:352-486-3607
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:OTTER CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:32683-0086
Mailing Address - Country:US
Mailing Address - Phone:352-486-3607
Mailing Address - Fax:
Practice Address - Street 1:351 SW STATE ROAD 24
Practice Address - Street 2:
Practice Address - City:OTTER CREEK
Practice Address - State:FL
Practice Address - Zip Code:32683
Practice Address - Country:US
Practice Address - Phone:352-486-3607
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-22
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services