Clark Enterprises 407 LLC

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

Legal business name

CLARK ENTERPRISES 407 LLC

Doing business as

Comfort Keepers

Practice address

1398 N Oakland Ave
Decatur, IL 62526-3737

Phone

(217) 429-6666

Fax

(217) 429-3620

NPI assigned

Dec 31, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Christina Lynn Clark

Title

Owner

Phone

(217) 429-6666

Specialties & licenses 1

Addresses

Other names 1

• Comfort Keepers Doing business as

Tax ID family

Clark Enterprises 407 LLC2 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.

• Clark Enterprises 407 LLC

  • In Home Supportive Care Agency
  • Decatur, IL
  • NPI 1740432152
  NPD tax ID

Locations

Practitioners 1

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

• Jason Blunck

  • Home Health Aide
  • Decatur, IL
  • NPI 1215634589
  NPD (past)

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

{
    "created_epoch": "1199059200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1199059200000",
    "number": "1396920062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1398 N OAKLAND AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263737",
            "telephone_number": "217-429-6666",
            "fax_number": "217-429-3620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1398 N OAKLAND AVE",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263737",
            "telephone_number": "217-429-6666",
            "fax_number": "217-429-3620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK ENTERPRISES 407 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-31",
        "last_updated": "2007-12-31",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "CHRISTINA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "217-429-6666",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Keepers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Choudary V. Kavuri MD, SC
• Larry Lee Christensen, RPH
• Jeffrey Paul Christy II
• Larisa Georgy Ciatlos-Deak, MD
• Breanne Joleen Clair, MS, CCC-SLP
• Clark Enterprises 407 LLC
• Amber Teresa Clark, LCSW
• Hailee Clark
• Kelly Clark, DDS
• Mark C Clarke, MD

• Home Health Agency in Decatur, IL
• Providers in Decatur, IL by specialty
• Home Health Agency in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2007; 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.