Clark Supported Living

LBN: Clark Supported Living
Clark Supported Living is an health care organization with primary practice located at 303 Macaw Dr , Columbia MO 65202. The organization recently has 15 registered licenses in different health care specialties including Nursing Service Providers / Community Health, Other Service Providers / Meals, Agencies / Case Management, Agencies / Nursing Care, Agencies / Community/Behavioral Health, Agencies / Supports Brokerage, Agencies / In Home Supportive Care, Ambulatory Health Care Facilities / Adult Day Care, Ambulatory Health Care Facilities / Developmental Disabilities, Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Respite Care Facility / Respite Care, Mental Illness, Child, Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities, Respite Care Facility / Respite Care, Physical Disabilities, Child. Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities is the primary health care specialty. Clark Supported Living can be contacted via phone (773) 332-6106, or through Clark, Zondra D via phone (773) 332-6106.

Contact Information

Primary practice address
303 Macaw Dr Columbia MO 65202
Phone: (773) 332-6106
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Zondra D Registered Nurse (RN)
Phone: (773) 332-6106

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Community Health 163WC1500X
Other Service Providers / Meals 174200000X
Agencies / Case Management 251B00000X
Agencies / Nursing Care 251J00000X
Agencies / Community/Behavioral Health 251S00000X
Agencies / Supports Brokerage 251X00000X
Agencies / In Home Supportive Care 253Z00000X
Ambulatory Health Care Facilities / Adult Day Care 261QA0600X
Ambulatory Health Care Facilities / Developmental Disabilities 261QD1600X
Residential Treatment Facilities / Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320600000X
Residential Treatment Facilities / Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities 320900000X
Respite Care Facility / Respite Care 385H00000X
Respite Care Facility / Respite Care, Mental Illness, Child 385HR2055X
Respite Care Facility / Respite Care, Mental Retardation and/or Developmental Disabilities 385HR2060X
Respite Care Facility / Respite Care, Physical Disabilities, Child 385HR2065X

Profile Details

NPI number 1326514381
LBN Legal business name Clark Supported Living
DBA Doing business as
Authorized official Clark, Zondra D Registered Nurse (RN)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 17th, 2018
Last updated Oct 17th, 2018 - about 6 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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