MEDICARE: AYTONS ARK OF GRACE HOME CARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251J00000X	Nursing Care Agency

General Provider Information

NPI Number	:	1760316913
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AYTONS ARK OF GRACE HOME CARE LLC

Provider Business Mailing Address
First Line	:	801 NW 4TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7214
Country	:	US
Telephone Number	:	954-296-2659
Fax Number	:	954-296-2659

Provider Business Practice Location Address
First Line	:	801 NW 4TH AVE
Second Line	:
City	:	FORT LAUDERDALE
State	:	FL
Zip	:	33311-7214
Country	:	US
Telephone Number	:	954-296-2659
Fax Number	:	954-296-2659

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MARQUASHA AYTON
Credential	:
Telephone Number	:	954-296-2659

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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