Arca - Park

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

License

5021 Issued in NM

Legal business name

ARCA - PARK

Practice address

1120 Louisiana Blvd SE
Albuquerque, NM 87108-5009

Phone

(505) 332-6814

Fax

(505) 332-6800

NPI assigned

Feb 20, 2007

Last updated

Jun 4, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Vnce Smith

Title

Director

Phone

(505) 332-6814

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1740325588. Details of each certification follow.

• CCN 32G013 Intermediate care facility for individuals with intellectual disabilities · Active · Name & address match · Details

Intermediate care facility for individuals with intellectual disabilities certification: CCN 32G013

Legal name

ARCA Park Home

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Apr 2, 1985

Last certification

Jan 8, 2025

Beds

10

Ownership / control type

Private (non-profit)

Facility address

1120 Louisiana Blvd SE
Albuquerque, NM 87108

Tax ID family

Arca19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

Organizations that report the same tax identification number in the National Provider Directory.

• Arca

  • Community/Behavioral Health Agency
  • Albuquerque, NM
  • NPI 1023672516
  NPD tax ID
• Arca

  • In Home Supportive Care Agency
  • Albuquerque, NM
  • NPI 1073177580
  NPD tax ID
• Arca

  • Assisted Living Facility
  • Albuquerque, NM
  • NPI 1134766413
  NPD tax ID
• Arca

  • Assisted Living Facility
  • Albuquerque, NM
  • NPI 1215504642
  NPD tax ID
• Arca

  • Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
  • Albuquerque, NM
  • NPI 1306955026
  NPD tax ID
• Arca

  • Home Health Agency
  • Albuquerque, NM
  • NPI 1336890862
  NPD tax ID
• Arca

  • Assisted Living Facility
  • Albuquerque, NM
  • NPI 1467016964
  NPD tax ID
• Arca

  • Assisted Living Facility
  • Albuquerque, NM
  • NPI 1477122380
  NPD tax ID
• Arca

  • Adult Day Care Clinic/Center
  • Albuquerque, NM
  • NPI 1508420019
  NPD tax ID
• Arca

  • Assisted Living Facility
  • Albuquerque, NM
  • NPI 1528727534
  NPD tax ID
• Arca

  • Respite Care
  • Albuquerque, NM
  • NPI 1538723036
  NPD tax ID
• Arca

  • Foster Care Agency
  • Albuquerque, NM
  • NPI 1679137178
  NPD tax ID

Locations

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1740325588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11300 LOMAS BLVD NE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871125512",
            "telephone_number": "505-332-6814",
            "fax_number": "505-332-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 LOUISIANA BLVD SE",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871085009",
            "telephone_number": "505-332-6814",
            "fax_number": "505-332-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCA - PARK",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "VNCE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "505-332-6814",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": "NM",
            "license": "5021",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "M5013",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Arca
• Arca
• Arca - Copper Home
• Arca - Gibson Home
• Arca - Louisiana
• Arca - South Valley
• Arca - Trumbull
• Sarah Jean Archer, RN
• Marguerite Archibeck
• Michael J Archibeck, M.D.

• Intellectual Disabilities Intermediate Care Facility in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Intellectual Disabilities Intermediate Care Facility in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.