Individual
ALAYSHA CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11309 CHILLY WATER CT, RIVERVIEW, FL 33569-2059
(813) 507-5878
Mailing address
11309 CHILLY WATER CT, RIVERVIEW, FL 33569-2059
(813) 507-5878
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
—
FL
311ZA0620X
Adult Care Home Facility
Primary
—
FL
Other
Enumeration date
05/26/2022
Last updated
04/25/2026
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