NPIMap

Organization Active NPI

Clark Retirement Community Inc.

  • Home Health Agency
  • Grand Rapids, MI
National Provider Identifier
1174771026
Registry record updated May 14, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
Legal business name
CLARK RETIREMENT COMMUNITY INC.
Practice address
1551 Franklin St SE
Grand Rapids, MI 49506-8203
Phone
(616) 452-1568
Fax
(616) 452-0428
NPI assigned
Sep 4, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 14, 2009

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

Authorized official

Name
Ms. Stephanie Lynn Hotz
Title
Accounts Receivable Coordinator
Phone
(616) 452-1568

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X Primary

Addresses

Primary practice location

1551 Franklin St SE
Grand Rapids, MI 49506-8203

Mailing address

1551 Franklin St SE
Grand Rapids, MI 49506-8203
Phone (616) 452-1568

Other names 1

  • Clark at Home Personal Services Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Clark Retirement Community Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242259200000",
    "number": "1174771026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1551 FRANKLIN ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495068203",
            "telephone_number": "616-452-1568",
            "fax_number": "616-452-0428"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1551 FRANKLIN ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495068203",
            "telephone_number": "616-452-1568",
            "fax_number": "616-452-0428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK RETIREMENT COMMUNITY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-04",
        "last_updated": "2009-05-14",
        "status": "A",
        "authorized_official_last_name": "HOTZ",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "ACCOUNTS RECEIVABLE COORDINATOR",
        "authorized_official_telephone_number": "616-452-1568",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clark at Home Personal Services",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2009; 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.