Individual
JESSICA CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
132 CENTER AVE, BLACK MOUNTAIN, NC 28711-3509
(910) 417-7351
Mailing address
PO BOX 897, BLACK MOUNTAIN, NC 28711-0897
(910) 417-7351
Taxonomy
Speciality
Code
Description
License number
State
310400000X
Assisted Living Facility
Primary
FCL-011
NC
Other
Enumeration date
03/23/2016
Last updated
10/20/2023
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