Healthcare Provider Details

I. General information

NPI: 1093534737
Provider Name (Legal Business Name): ARK OF REHABILITATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/09/2024
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5610 HARFORD RD STE A
BALTIMORE MD
21214-2247
US

IV. Provider business mailing address

5610 HARFORD RD STE A
BALTIMORE MD
21214-2247
US

V. Phone/Fax

Practice location:
  • Phone: 443-405-8005
  • Fax: 443-815-4746
Mailing address:
  • Phone: 240-505-4750
  • Fax: 443-815-4746

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number
License Number StateNULL

VIII. Authorized Official

Name: JOANNAH K ALABI-ONI
Title or Position: ADMIN
Credential:
Phone: 240-505-4750