Organization
HEAVEN'S ARK, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DANA MARTIN (CEO/OWNER)
(215) 817-2528
Entity
Organization
Contact information
Practice address
6605 HAVERFORD AVE, PHILADELPHIA, PA 19151-3620
(215) 817-8156
Mailing address
6605 HAVERFORD AVE, PHILADELPHIA, PA 19151-3620
(215) 817-8156
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037522440001
—
PA
Enumeration date
04/09/2021
Last updated
05/31/2021
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