Provider Demographics
NPI:1437691193
Name:LARK HOME CARE INC.
Entity Type:Organization
Organization Name:LARK HOME CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SVETLANA
Authorized Official - Middle Name:
Authorized Official - Last Name:HOPCUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-423-0728
Mailing Address - Street 1:12500 W 58TH AVE
Mailing Address - Street 2:UNIT 103
Mailing Address - City:ARVADA
Mailing Address - State:CO
Mailing Address - Zip Code:80002-1103
Mailing Address - Country:US
Mailing Address - Phone:303-423-0728
Mailing Address - Fax:303-423-0898
Practice Address - Street 1:12500 W 58TH AVE
Practice Address - Street 2:UNIT 103
Practice Address - City:ARVADA
Practice Address - State:CO
Practice Address - Zip Code:80002-1103
Practice Address - Country:US
Practice Address - Phone:303-423-0728
Practice Address - Fax:303-423-0898
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-12
Last Update Date:2021-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251E00000X
CO04S549253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
No251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO9000103270Medicaid
CO56700059Medicaid