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General NPI Number Information
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NPI Number | 1356093447
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Entity Type | Organization
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Legal Business Name | ARK MENTAL HEALTH LLC
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Dates
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Enumeration Date | 01/20/2022
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Last Update Date | 01/20/2022
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Provider Practice Location Address
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Address Line | 154 S 7TH ST
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City | SALINA
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State | KS
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Zip | 67401-2806
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Country | US
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Telephone | 785-577-7833
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Fax |
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Provider Business Mailing Address
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Address Line | 3180 E COUNTRY CLUB RD
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City | SALINA
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State | KS
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Zip | 67401-9527
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Country | US
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Telephone | 785-205-0756
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RANDI NICOLE ELOISE KIRK
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Credential | PMHNP-BC
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Telephone | 785-502-0756
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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