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Organization

THE ARC OF WALTON COUNTY, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. KIMBERLY J LONAS (EXECUTIVE DIRECTOR)
(850) 892-5013
Entity
Organization

Contact information

Practice address
1408A HIGHWAY 83 N, DEFUNIAK SPRINGS, FL 32433-3817
(850) 892-5013
Mailing address
PO BOX 813, DEFUNIAK SPRINGS, FL 32435-0813
(850) 892-5013
(850) 892-7895

Taxonomy

Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
024511998
FL
251V00000X
Voluntary or Charitable Agency
253Z00000X
In Home Supportive Care Agency
024511998
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002815900
FL
01
024511996
MEDICAID WAIVER
FL
01
024511998
MEDICAID WAIVER
FL
Enumeration date
09/16/2011
Last updated
09/16/2011
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