Organization Active NPI

Arms Acres Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Chester, NY
National Provider Identifier
1407046998
Registry record updated Apr 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X
License
100210666 Issued in NY
Legal business name
ARMS ACRES INC
Practice address
3 Maple Ave
Chester, NY 10918-1324
Phone
(845) 469-2220
Fax
(845) 469-4011
NPI assigned
Jul 31, 2007
Last updated
Apr 29, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Patrice Wallace-Moore, LCSW-R
Title
Executive Director, Liberty MGT
Phone
(888) 227-4641

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X 100210666 NY Primary

Addresses

Primary practice location

3 Maple Ave
Chester, NY 10918-1324

Mailing address

PO Box 1841
Albany, NY 12201-1841
Phone (518) 952-8408

Other identifiers 1

IdentifierTypeStateIssuer
01420795MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040326000447 NY Part B Supplier - Clinic/Group Practice 8820980691 Receives reassigned benefits from 16 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Bronx, NY; Carmel, NY; Jamaica, NY

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

3 Maple Ave
Chester, NY 10918
Phone (845) 469-2220

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1185840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619654400000",
    "number": "1407046998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1841",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122011841",
            "telephone_number": "518-952-8408",
            "fax_number": "518-399-6860"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 MAPLE AVE",
            "city": "CHESTER",
            "state": "NY",
            "postal_code": "109181324",
            "telephone_number": "845-469-2220",
            "fax_number": "845-469-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARMS ACRES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-31",
        "last_updated": "2021-04-29",
        "certification_date": "2021-04-29",
        "status": "A",
        "authorized_official_last_name": "WALLACE-MOORE",
        "authorized_official_first_name": "PATRICE",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR, LIBERTY MGT",
        "authorized_official_telephone_number": "888-227-4641",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "100210666",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01420795",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chester, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.