Provider Demographics
NPI:1306509856
Name:DELARK2 CARE INCORPORATED
Entity type:Organization
Organization Name:DELARK2 CARE INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:KENDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:BLAND
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:870-563-0358
Mailing Address - Street 1:515 W LEE AVE
Mailing Address - Street 2:
Mailing Address - City:OSCEOLA
Mailing Address - State:AR
Mailing Address - Zip Code:72370-3115
Mailing Address - Country:US
Mailing Address - Phone:870-563-0358
Mailing Address - Fax:870-563-0359
Practice Address - Street 1:515 W LEE AVE
Practice Address - Street 2:
Practice Address - City:OSCEOLA
Practice Address - State:AR
Practice Address - Zip Code:72370-3115
Practice Address - Country:US
Practice Address - Phone:870-563-0358
Practice Address - Fax:870-563-0359
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-20
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR274341797Medicaid
AR267256732Medicaid
AR274345757Medicaid