Provider Demographics
NPI:1700079597
Name:THE ARK FAMILY COUNSELING CENTER, INC.
Entity Type:Organization
Organization Name:THE ARK FAMILY COUNSELING CENTER, INC.
Other - Org Name:RICKY HOMES
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:DAINO
Authorized Official - Middle Name:DANTE
Authorized Official - Last Name:DEAS
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:678-858-5308
Mailing Address - Street 1:PO BOX 360997
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30036-0997
Mailing Address - Country:US
Mailing Address - Phone:770-593-0913
Mailing Address - Fax:
Practice Address - Street 1:4256 CLAUSELL CT
Practice Address - Street 2:SUITE 300B
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30035-1903
Practice Address - Country:US
Practice Address - Phone:770-593-0913
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-24
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health