Active NPI
The Arc of Macon
- In Home Supportive Care Agency
- Macon, GA
National Provider Identifier
1013269992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- In Home Supportive Care Agency
- License
- 011-R-0040
- Legal business name
- THE ARC OF MACON
- Practice address
- 4664 Sheraton Dr
Macon, GA 31210-1322 - Phone
- (478) 477-7764
- Fax
- (478) 477-8824
- NPI assigned
- Oct 3, 2012
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Kenneth Andrew Harrell, LCSW
- Title
- Chief Administrative Officer
- Phone
- (478) 477-7764
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| In Home Supportive Care Agency | 253Z00000X | 011-R-0040 | GA | Primary |
Addresses
Primary practice location
4664 Sheraton Dr
Macon, GA 31210-1322
Mailing address
4664 Sheraton Dr
Macon, GA 31210-1322
Phone (478) 477-7764
National Provider Directory
National Provider Directory- Tax ID family
- Advocacy Resource Center Inc - Macon
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
- Macon, GA
- NPI 1790999886
Locations
4664 Sheraton Dr
Macon, GA 31210
Phone (478) 477-7764
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1349222400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1349222400000",
"number": "1013269992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4664 SHERATON DR",
"city": "MACON",
"state": "GA",
"postal_code": "312101322",
"telephone_number": "478-477-7764",
"fax_number": "478-477-8824"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4664 SHERATON DR",
"city": "MACON",
"state": "GA",
"postal_code": "312101322",
"telephone_number": "478-477-7764",
"fax_number": "478-477-8824"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "THE ARC OF MACON",
"organizational_subpart": "NO",
"enumeration_date": "2012-10-03",
"last_updated": "2012-10-03",
"status": "A",
"authorized_official_last_name": "HARRELL",
"authorized_official_first_name": "KENNETH",
"authorized_official_middle_name": "ANDREW",
"authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
"authorized_official_telephone_number": "478-477-7764",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "LCSW"
},
"taxonomies": [
{
"code": "253Z00000X",
"taxonomy_group": "",
"desc": "In Home Supportive Care",
"state": "GA",
"license": "011-R-0040",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Macon, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.