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Organization
STONE BELT ARC, INC
Active
Organization
STONE BELT ARC, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE GREEN (CEO)
(812) 332-2168
Entity
Organization
Contact information
Practice address
4100 E DECKARD DR, BLOOMINGTON, IN 47408-2806
(812) 333-1526
Mailing address
2815 E 10TH ST, BLOOMINGTON, IN 47408-2601
Taxonomy
Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary
2632S0011DE05
IN
Other
Enumeration date
12/01/2006
Last updated
08/22/2020
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