Healthcare Provider Details

I. General information

NPI: 1538431325
Provider Name (Legal Business Name): ARK HEALTH MANAGEMENT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

325 KEELSON DR
DETROIT MI
48215-3073
US

IV. Provider business mailing address

325 KEELSON DR
DETROIT MI
48215-3073
US

V. Phone/Fax

Practice location:
  • Phone: 214-864-1219
  • Fax: 866-262-9444
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name: LEONORA GIBSON
Title or Position: CEO
Credential:
Phone: 214-864-1219