Provider Demographics
NPI:1861229510
Name:ARK OF COVENANT CARE
Entity type:Organization
Organization Name:ARK OF COVENANT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:AYODELE
Authorized Official - Middle Name:
Authorized Official - Last Name:OYEBADE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-746-2009
Mailing Address - Street 1:351 SEYMOUR AVE
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07112-2134
Mailing Address - Country:US
Mailing Address - Phone:848-252-8172
Mailing Address - Fax:
Practice Address - Street 1:351 SEYMOUR AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2134
Practice Address - Country:US
Practice Address - Phone:848-252-8172
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-09-17
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3104A0625XNursing & Custodial Care FacilitiesAssisted Living FacilityAssisted Living, Mental Illness
No177F00000XOther Service ProvidersLodging