Clinton E Clark

Individual provider Active NPI Home Health Agency · East Cleveland, OH

NPI 1033802137 · NPPES record last updated Jun 2, 2023

Key facts

NPI
1033802137
Entity type
Individual (NPI type 1)
Primary specialty
Home Health Agency 251E00000X
Practice address
1183 Carlyon Rd
East Cleveland, OH 44112-4163
Phone
(216) 408-7353
NPI assigned
Jun 2, 2023
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Worker 172V00000X
Home Health Agency 251E00000X Yes

Addresses

Primary practice location

1183 Carlyon Rd
East Cleveland, OH 44112-4163

Mailing address

25000 Euclid Ave Ste 305
Euclid, OH 44117-2646
Phone (216) 408-7353

Other providers in East Cleveland, OH

All providers in East Cleveland, OH · Home Health Agency in Ohio

Sources for this page

Verify at the official NPI Registry.