Organization
WM CLARK ALZ CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROMINIC CLARK (EXECUTIVE DIRECTOR)
(901) 267-4002
Entity
Organization
Contact information
Practice address
6222 EAST SHEBY DRIVE, MEMPHIS, TN 38141-7735
(901) 267-4002
Mailing address
3150 WOODLAND FIR DR, LAKELAND, TN 38002-3957
(901) 267-4002
Taxonomy
Speciality
Code
Description
License number
State
261QA0600X
Adult Day Care Clinic/Center
Primary
—
—
Other
Enumeration date
03/16/2017
Last updated
03/29/2017
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