Healthcare Provider Details

I. General information

NPI: 1487595138
Provider Name (Legal Business Name): ARK CARE HOME, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/04/2026
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37616 RIBBON LN
PALMDALE CA
93552-4031
US

IV. Provider business mailing address

37616 RIBBON LN
PALMDALE CA
93552-4031
US

V. Phone/Fax

Practice location:
  • Phone: 818-415-2653
  • Fax: 661-526-4066
Mailing address:
  • Phone: 818-415-2653
  • Fax: 661-526-4066

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code310400000X
TaxonomyAssisted Living Facility
License Number
License Number State

VIII. Authorized Official

Name: MR. RICHARD MANDAC
Title or Position: OWNER/ADMINISTRATOR
Credential:
Phone: 818-415-2653