Clark, Ileha M

Clark, Ileha M is an sole proprietor health care provider with primary practice located at 152 New St Ste 103M , Macon GA 31201-7304. She recently has 2 registered licenses in different health care specialties including Nursing Service Related Providers / Chore Provider, Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization. Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization is her primary health care specialty. Clark, Ileha M can be contacted via phone (478) 508-7124.

Contact Information

Primary practice address
152 New St Ste 103M Macon GA 31201-7304
Phone: (478) 508-7124
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Related Providers / Chore Provider 372500000X
Agencies / Program of All-Inclusive Care for the Elderly (PACE) Provider Organization 251T00000X

Profile Details

NPI number 1619531936
LBN Legal business name Clark, Ileha M
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 23rd, 2019
Last updated May 3rd, 2019 - about 6 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.

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