# WAYNE ARC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Roosevelt Children's Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770881583
- **Authorized official:** MRS. DEBORAH ANN SCHALLMO OTR/L (COORDINATOR OF OCCUPATIONAL THERAPY)
- **Authorized official phone:** (315) 331-2086

## Contact information

- **Practice address:** 848 PEIRSON AVE, NEWARK, NY 14513-9762
- **Practice address phone:** (315) 331-2086
- **Practice address fax:** (315) 331-3215
- **Mailing address:** 848 PEIRSON AVE, NEWARK, NY 14513-9762
- **Mailing address phone:** (315) 331-2086
- **Mailing address fax:** (315) 331-3215

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 252Y00000X | Early Intervention Provider Agency | 009453 | NY | Yes |

## Other

- **Enumeration date:** 03/02/2011
- **Last updated:** 03/02/2011