Clark Nursing and Rehabilitation Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

License

5200 Issued in IN

Legal business name

CLARK NURSING AND REHABILITATION CENTER, LLC

Doing business as

Clark Nursing and Rehabilitation Center

Practice address

1964 Clark Rd
Gary, IN 46404-2550

Phone

(219) 949-9640

Fax

(219) 949-9693

NPI assigned

Mar 28, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark Steingberg

Title

Chief Operating Officer

Phone

(847) 905-3000

Specialties & licenses 1

Addresses

Other names 1

• Clark Nursing and Rehabilitation Center Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Richenel Samuel Ellecom, PSY.D; DR.P.H

  • Registered Dietitian
  • Willow Brook, IL
  • NPI 1063406569
  NPD (past)
• Sherrie Cecile Godbolt, M.D.

  • Psychiatry Physician
  • South Holland, IL
  • NPI 1114027828
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1114046463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1964 CLARK RD",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464042550",
            "telephone_number": "219-949-9640",
            "fax_number": "219-949-9693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1964 CLARK RD",
            "city": "GARY",
            "state": "IN",
            "postal_code": "464042550",
            "telephone_number": "219-949-9640",
            "fax_number": "219-949-9693"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK NURSING AND REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEINGBERG",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "847-905-3000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "IN",
            "license": "5200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark Nursing and Rehabilitation Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Chube Medical Corporation
• David Damaret Chube, M.D.
• Chube2 Primary Care LLC
• City of Gary Fire Department, EMS
• City of Gary Indiana
• Cornelius Clark Jr.
• Marsha Clark, RN
• Claudette Dandridge M.D.
• Susan Clay
• April Clayborne

• Skilled Nursing Facility in Gary, IN
• Providers in Gary, IN by specialty
• Skilled Nursing Facility in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.