Organization
CLARK SENIOR CARE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUDITH A. CLARK (OWNER/ADMINISTRATOR)
(207) 454-3709
Entity
Organization
Contact information
Practice address
526 SOUTH ST, CALAIS, ME 04619-1118
(207) 454-3709
Mailing address
526 SOUTH ST, CALAIS, ME 04619-1118
(207) 454-3709
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
ALLS3154
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
131220001
—
ME
Enumeration date
07/25/2009
Last updated
07/25/2009
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