# BOLD ARK LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1740079623
- **Authorized official:** OLUFUNKE MUKOMI ADEWUNMI DNP, PMHNP-BC (CEO)
- **Authorized official phone:** (678) 898-1927

## Contact information

- **Practice address:** 3905 HARRISON RD STE 500, LOGANVILLE, GA 30052-5895
- **Practice address phone:** (678) 898-1927
- **Practice address fax:** (678) 798-8880
- **Mailing address:** 3905 HARRISON RD STE 500, LOGANVILLE, GA 30052-5895
- **Mailing address phone:** (678) 898-1927
- **Mailing address fax:** (678) 798-8880

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/06/2025
- **Last updated:** 03/27/2026