Organization
ARK HOMES CONGREGATE LIVING HEALTH FACILITY
Active
Other names
Ark Homes Congregate Living Health Facility
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH J MATHIAS (AUTHORIZED OFFICIAL)
(626) 893-0589
Entity
Organization
Contact information
Practice address
12167 RICHFIELD DR, RANCHO CUCAMONGA, CA 91739-8910
(626) 893-0589
Mailing address
12167 RICHFIELD DR, RANCHO CUCAMONGA, CA 91739-8910
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
—
—
310400000X
Assisted Living Facility
—
—
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
—
—
314000000X
Skilled Nursing Facility
—
—
315D00000X
Inpatient Hospice
—
—
Other
Enumeration date
05/08/2023
Last updated
05/08/2023
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