Provider Demographics
NPI:1790459261
Name:ARK HOMECARE INC
Entity Type:Organization
Organization Name:ARK HOMECARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:GRACE
Authorized Official - Middle Name:
Authorized Official - Last Name:ENABOSI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-293-2852
Mailing Address - Street 1:1 ETHEL RD STE 102B
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-2838
Mailing Address - Country:US
Mailing Address - Phone:908-293-2852
Mailing Address - Fax:908-293-2853
Practice Address - Street 1:44 APPLE ST
Practice Address - Street 2:
Practice Address - City:TINTON FALLS
Practice Address - State:NJ
Practice Address - Zip Code:07724-2671
Practice Address - Country:US
Practice Address - Phone:908-293-2852
Practice Address - Fax:908-293-2853
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-08-06
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities