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Organization

WAYNE ARC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. DONNA ANN SMITH RN BSN (REGISTERED NURSE)
(315) 331-6482
Entity
Organization

Contact information

Practice address
150 VAN BUREN ST, NEWARK, NY 14513-1238
(315) 331-6482
(315) 331-6482
Mailing address
150 VANBUREN ST, NEWARK, NY 14513
(315) 331-6482
(315) 331-6482

Taxonomy

Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
485547-1
NY

Other

Enumeration date
07/24/2013
Last updated
07/24/2013
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