Provider Demographics
NPI:1922882000
Name:ARK OF REHABILITATION INC
Entity Type:Organization
Organization Name:ARK OF REHABILITATION INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:SAMUEL
Authorized Official - Middle Name:
Authorized Official - Last Name:ADEYEYE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:240-505-4750
Mailing Address - Street 1:8629 LIBERTY RD STE A
Mailing Address - Street 2:
Mailing Address - City:RANDALLSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21133-4713
Mailing Address - Country:US
Mailing Address - Phone:443-405-8005
Mailing Address - Fax:
Practice Address - Street 1:8629 LIBERTY RD STE A
Practice Address - Street 2:
Practice Address - City:RANDALLSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21133-4713
Practice Address - Country:US
Practice Address - Phone:443-405-8005
Practice Address - Fax:443-815-4746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-21
Last Update Date:2023-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No251B00000XAgenciesCase Management
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy