Healthcare Provider Details

I. General information

NPI: 1851194922
Provider Name (Legal Business Name): ARDENT CIRCLE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/21/2025
Certification Date: 04/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

309 COURT AVE STE 200
DES MOINES IA
50309-2230
US

IV. Provider business mailing address

3030 LAKE ARTHUR DR APT 26
PORT ARTHUR TX
77642-4442
US

V. Phone/Fax

Practice location:
  • Phone: 803-814-7824
  • Fax:
Mailing address:
  • Phone: 936-239-8228
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251J00000X
TaxonomyNursing Care Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number State

VIII. Authorized Official

Name: OCTAVIA S SKAKUN
Title or Position: CEO OF ARDENT CIRICLELLC
Credential:
Phone: 936-239-8228