Provider Demographics
NPI:1851763254
Name:ARA HOME HEALTH CARE INC
Entity type:Organization
Organization Name:ARA HOME HEALTH CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:RUBY
Authorized Official - Middle Name:J
Authorized Official - Last Name:STOCKDALE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:904-349-9827
Mailing Address - Street 1:664 LADY LAKE RD W
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32218-8469
Mailing Address - Country:US
Mailing Address - Phone:904-349-9827
Mailing Address - Fax:
Practice Address - Street 1:664 LADY LAKE RD W
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32218-8469
Practice Address - Country:US
Practice Address - Phone:904-349-9827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-24
Last Update Date:2015-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL253Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes253Z00000XAgenciesIn Home Supportive Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLPENDINGMedicaid