Provider Demographics
NPI:1790342095
Name:THE ARTISANS ARK
Entity Type:Organization
Organization Name:THE ARTISANS ARK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:POLLY
Authorized Official - Middle Name:
Authorized Official - Last Name:MAXWELL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:509-325-4489
Mailing Address - Street 1:PO BOX 6049
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99217
Mailing Address - Country:US
Mailing Address - Phone:519-325-4489
Mailing Address - Fax:509-325-5034
Practice Address - Street 1:4019 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217
Practice Address - Country:US
Practice Address - Phone:509-325-4489
Practice Address - Fax:509-325-5034
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-05-22
Last Update Date:2019-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251C00000XAgenciesDay Training, Developmentally Disabled Services