- Enrollment id
- O20241015002845
- Enrollment state
- CA
- Provider type code
- 00-06
- Provider type text
- PART A PROVIDER - HOME HEALTH AGENCY
- Npi
- 1528799632
- Multiple npi flag
- N
- Ccn
- 758122
- Associate id
- 6002348075
- Organization name
- ARK HOME HEALTH INC
- Organization type structure
- CORPORATION
- Proprietary nonprofit
- P
- Address line 1
- 222 N MOUNTAIN AVE
- Address line 2
- STE 211
- City
- UPLAND
- State
- CA
- Zip code
- 917865714
- Practice location type
- HHA BRANCH