Organization
ARC HOUSE OF ELAVATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ARDRIA L CLARK LPC (EXECUTIVE DIRECTOR)
(229) 403-7047
Entity
Organization
Contact information
Practice address
1102 E JACKSON ST, THOMASVILLE, GA 31792-4786
(229) 403-7047
(229) 289-1869
Mailing address
1102 E JACKSON ST STE 4, THOMASVILLE, GA 31792-4779
(229) 403-7047
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
—
—
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Enumeration date
03/12/2021
Last updated
03/12/2021
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