# CLARK FAMILY CARE HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1437438959
- **Authorized official:** TURISSA BRIGHT (CEO)
- **Authorized official phone:** (919) 207-6114

## Contact information

- **Practice address:** 167 SALEEN DR, WILLOW SPRING, NC 27592-7610
- **Practice address phone:** (919) 207-6114
- **Mailing address:** 167 SALEEN DR, WILLOW SPRING, NC 27592-7610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 311ZA0620X | Adult Care Home Facility | FCL-051-044 | NC | Yes |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | FCL-051-044 | NC | — |

## Other

- **Enumeration date:** 08/15/2011
- **Last updated:** 08/15/2011