Provider Demographics
NPI:1427624675
Name:LARK HOME CARE SVCS LLC
Entity type:Organization
Organization Name:LARK HOME CARE SVCS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRIDGETTA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOLUFEMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:210-273-1296
Mailing Address - Street 1:6114 BRISCOE LEAF
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5524
Mailing Address - Country:US
Mailing Address - Phone:210-273-1296
Mailing Address - Fax:
Practice Address - Street 1:6114 BRISCOE LEAF
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78253-5524
Practice Address - Country:US
Practice Address - Phone:210-273-1296
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health