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General NPI Number Information
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NPI Number | 1194177220
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Entity Type | Organization
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Legal Business Name | FRIENDSHIP ARK, INC.
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Dates
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Enumeration Date | 07/13/2016
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Last Update Date | 07/13/2016
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Provider Practice Location Address
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Address Line | 130 S SHELDON AVE SUITE #203
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City | AMES
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State | IA
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Zip | 50014-7287
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Country | US
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Telephone | 515-292-9556
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Fax | 515-268-8897
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Provider Business Mailing Address
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Address Line | 130 S SHELDON AVE SUITE #203
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City | AMES
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State | IA
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Zip | 50014-7287
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Country | US
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Telephone | 515-292-9556
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Fax | 515-268-8897
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JENNIFER ELLIS
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Credential |
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Telephone | 515-292-9556
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number |
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License Number State |
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