Provider Demographics
NPI:1639754526
Name:ARKS REST LLC
Entity Type:Organization
Organization Name:ARKS REST LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAPHET
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:801-923-8063
Mailing Address - Street 1:3222 BOUNTIFUL BLVD
Mailing Address - Street 2:
Mailing Address - City:BOUNTIFUL
Mailing Address - State:UT
Mailing Address - Zip Code:84010-4452
Mailing Address - Country:US
Mailing Address - Phone:909-645-1922
Mailing Address - Fax:
Practice Address - Street 1:3222 BOUNTIFUL BLVD
Practice Address - Street 2:
Practice Address - City:BOUNTIFUL
Practice Address - State:UT
Practice Address - Zip Code:84010-4452
Practice Address - Country:US
Practice Address - Phone:909-645-1922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-12
Last Update Date:2021-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251J00000XAgenciesNursing Care