MEDICARE: ARK HAVEN 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	3747P1801X	Personal Care Attendant

General Provider Information

NPI Number	:	1831062793
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ARK HAVEN CARE LLC

Provider Business Mailing Address
First Line	:	522 E AVENUE K STE 7
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-2402
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	522 E AVENUE K STE 7
Second Line	:
City	:	GRAND PRAIRIE
State	:	TX
Zip	:	75050-2402
Country	:	US
Telephone Number	:	469-426-1725
Fax Number	:

Authorized Official
Title or Position	:	OWNER/VICE PRESIDENT
Name	:	KIMBERLY DAVONG
Credential	:
Telephone Number	:	469-426-1725

Provider Enumeration Date	:	09/26/2025
Last Update Date	:	06/11/2026

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Directions to “ARK HAVEN CARE LLC ” Practice Location

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