Provider Demographics
NPI:1295583326
Name:ARK HOME CARE
Entity type:Organization
Organization Name:ARK HOME CARE
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 1:10 LANIDEX PLZ W STE 130A
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-0228
Practice Address - Country:US
Practice Address - Phone:908-293-2852
Practice Address - Fax:908-293-2853
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ARK HOME CARE
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-05-13
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320900000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities