Organization
ALYCE D. CLARK
Active
Organization
ALYCE D. CLARK
Active
Other names
Shepherd's Lane
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALYCE DENISE CLARK RN, BSN (OWNER)
(816) 943-1300
Entity
Organization
Contact information
Practice address
10640 HOLMES ROAD, KANSAS CITY, MO 64131-3404
(816) 943-1300
(816) 942-7443
Mailing address
10640 HOLMES RD, KANSAS CITY, MO 64131-3404
(816) 943-1300
(816) 942-7443
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
856274402
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
8002103
DMH VENDOR NUMBER
MO
05
—
856274402
—
MO
Enumeration date
03/27/2007
Last updated
07/29/2008
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up