Provider Demographics
NPI:1760004493
Name:LARK HOME CARE, LLC
Entity Type:Organization
Organization Name:LARK HOME CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLII
Authorized Official - Middle Name:
Authorized Official - Last Name:WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-846-7103
Mailing Address - Street 1:12500 BARKER CYPRESS RD APT 10307
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-8268
Mailing Address - Country:US
Mailing Address - Phone:586-846-7103
Mailing Address - Fax:586-477-4687
Practice Address - Street 1:12500 BARKER CYPRESS RD APT 10307
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-8268
Practice Address - Country:US
Practice Address - Phone:586-846-7103
Practice Address - Fax:586-477-4687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-15
Last Update Date:2020-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care