ALICE CLARK (NPI# 1063589299) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063589299 |
| Entity Type | Individual |
| Full Name | ALICE CLARK |
| Other Name | RONALD CLARK |
| Practice Address |
10720 E. Marigold Lane Florence AZ 85232 |
| Practice Telephone | 5207238228 |
| Mailing Telephone | 5207238228 |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
10784 | AZ | Respite Care Facility |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | AHCCCS ID | 988321 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821374372 | Alice Clark | Lactation Consultant, Non-RN | 1776 Fair Ave, Simi Valley, CA 93063-3228 | 2011-10-28 |
| 1285641670 | Alice L Clark | Social Worker | 1114 W Pioneer Pkwy, Arlington, TX 76013-6367 | 2006-08-01 |
| 1033501382 | Alice Halsey Clark | Registered Nurse | 10362 Sw Mcdonald, Tigard, OR 97224 | 2015-02-24 |
| 1831455708 | Alice Clark | Licensed Practical Nurse | 4 Jefferson Plz, Poughkeepsie, NY 12601-4035 | 2012-04-05 |
| 1598813073 | Alice Ann Clark | Psychologist | 55 S Main St, Waterbury, VT 05676-1556 | 2007-01-08 |
| 1760495329 | Alice M Clark | Counselor | 5377 Manhattan Cir, Suite 200, Boulder, CO 80303-4333 | 2006-08-14 |
| Street Address |
10720 E. MARIGOLD LANE |
| City | FLORENCE |
| State | AZ |
| Zip Code | 85232 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508172198 | Hayley Benson | Physical Therapist | 448 E Butte Ave, Ste 3, Florence, AZ 85232 | 2010-08-20 |
| 1942537154 | Florence Ltc, LLC | Skilled Nursing Facility | 450 West Adamsville Road, Florence, AZ 85232 | 2009-11-09 |
| 1255566477 | State of Arizona Department of Corrections | Clinic/Center | 1305 E Butte Ave, Florence, AZ 85232 | 2009-05-18 |
| 1275780439 | Jason K Whetten | Dentist | 46 E 11th St, Florence, AZ 85232 | 2008-08-19 |
| 1578741351 | John A. Riley, PC | Optometrist | 360 N. Main Street, Florence, AZ 85232 | 2008-02-05 |
| 1093990160 | Core Chiropractic, LLC | Chiropractor | 6716 East Heritage Road, Florence, AZ 85232 | 2008-01-08 |
| 1881888790 | Jacqueline Lee Miller | Speech-Language Pathologist | 2700 N. Anthem Way, Florence, AZ 85232 | 2007-09-04 |
| 1487869673 | Noelle Kay White | Occupational Therapist | 255 S Orlando St, Florence, AZ 85232 | 2007-05-11 |
| 1790901106 | Pinal County Public Health Department | Public Health or Welfare | 500 S. Central, Florence, AZ 85232 | 2007-04-17 |
| 1366594350 | Dorinda S. Kroymann-moens | Physical Therapist | 225 South Orlando, Room 26, Florence, AZ 85232 | 2007-01-18 |
| Find all providers in zip 85232 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629264494 | Patricia Turner | Respite Care | 3472 N Spyglass Dr, Florence, AZ 85232-7521 | 2007-09-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114539004 | Yvette I Haughton | Respite Care | 11275 N 99th Ave Lot 117, Peoria, AZ 85345-5479 | 2020-08-20 |
| 1700411576 | Jaquelina Andrea Reyes | Respite Care | 25279 W Centre Ave, Buckeye, AZ 85326-2468 | 2020-03-11 |
| 1740815497 | Jerome Alexander-terrell Jackson | Respite Care | 9680 W Northern Ave Unit 2311, Peoria, AZ 85345-4655 | 2020-03-03 |
| 1912539941 | Elizabeth Ann Mannel | Respite Care | 1225 W Panorama Rd, Tucson, AZ 85704-2834 | 2020-02-07 |
| 1093345498 | New Hope of Arizona, Inc. | Respite Care | 12545 W Woodland Ave, Avondale, AZ 85323-8025 | 2020-01-24 |
| 1033757877 | Jessica Annette Dixon-tatum | Respite Care | 401 N 6th St, Buckeye, AZ 85326-2415 | 2019-12-11 |
| 1700423902 | Randy Bland | Respite Care | 20731 W Stone Hill Road, Buckeye, AZ 85396 | 2019-12-06 |
| 1003459934 | Stephanie Denise Jackson | Respite Care | 22321 W Morning Glory St, Buckeye, AZ 85326-7181 | 2019-10-23 |
| 1285276345 | Charlyn Ponds | Respite Care | 235 E Ray Rd Apt 2035, Chandler, AZ 85225-3362 | 2019-10-10 |
| 1508416595 | Tyechia Webb | Respite Care | 21239 N 24th Ave Apt 214, Phoenix, AZ 85027-2524 | 2019-09-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on ALICE CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.