Provider Demographics
NPI:1558631846
Name:THE ARK LLC
Entity Type:Organization
Organization Name:THE ARK LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:L
Authorized Official - Last Name:OWENS
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:907-235-7942
Mailing Address - Street 1:1136 SEABREEZE CT
Mailing Address - Street 2:
Mailing Address - City:HOMER
Mailing Address - State:AK
Mailing Address - Zip Code:99603-7935
Mailing Address - Country:US
Mailing Address - Phone:907-235-7942
Mailing Address - Fax:907-235-8851
Practice Address - Street 1:1136 SEABREEZE CT
Practice Address - Street 2:
Practice Address - City:HOMER
Practice Address - State:AK
Practice Address - Zip Code:99603-7935
Practice Address - Country:US
Practice Address - Phone:907-235-7942
Practice Address - Fax:907-235-8851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-04
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK967467310400000X, 311500000X, 385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility
No311500000XNursing & Custodial Care FacilitiesAlzheimer Center (Dementia Center)
No385H00000XRespite Care FacilityRespite Care