Clark, Alice
Clark, Alice is an sole proprietor health care provider with primary practice located at 10720 E. Marigold Lane , Florence AZ 85232. She recently has only one registered license in Respite Care Facility / Respite Care, Mental Illness, Child, which is considered as her primary health care specialty. Clark, Alice can be contacted via phone (520) 723-8228.Contact Information
Primary practice address
10720 E. Marigold Lane
Florence AZ 85232
Phone: (520) 723-8228
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respite Care Facility / Respite Care, Mental Illness, Child | 385HR2055X | 10784 | Arizona |
Profile Details
| NPI number | 1063589299 |
|---|---|
| LBN Legal business name | Clark, Alice |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 30th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1063589299 | NPPES |
| Arizona | Other | 988321 | AHCCCS ID |
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