Clark Family Care Home

Primary specialty

Adult Care Home FacilityTaxonomy code 311ZA0620X

License

FCL-051-044 Issued in NC

Legal business name

CLARK FAMILY CARE HOME

Practice address

167 Saleen Dr
Willow Spring, NC 27592-7610

Phone

(919) 207-6114

NPI assigned

Aug 15, 2011

Last updated

Aug 15, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Turissa Bright

Title

Ceo

Phone

(919) 207-6114

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1313366400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1313366400000",
    "number": "1437438959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 SALEEN DR",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275927610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 SALEEN DR",
            "city": "WILLOW SPRING",
            "state": "NC",
            "postal_code": "275927610",
            "telephone_number": "919-207-6114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK FAMILY CARE HOME",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-15",
        "last_updated": "2011-08-15",
        "status": "A",
        "authorized_official_last_name": "BRIGHT",
        "authorized_official_first_name": "TURISSA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "919-207-6114"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "NC",
            "license": "FCL-051-044",
            "primary": true
        },
        {
            "code": "320600000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
            "state": "NC",
            "license": "FCL-051-044",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth K Broughton, MOT, OTR/L
• Alan L Byrd, OD
• Candice Castleberry
• Avery Chase
• Alison Bethany Chavarriaga, MS, CCC-SLP
• April Clark
• Commissioned Health PLLC
• Jonathan Cordell, PSYD
• Nicole Diana Coughlin, M.S., CCC-SLP
• Christian Davis, LCSWA, LCAS

• Adult Care Home Facility in Willow Spring, NC
• Providers in Willow Spring, NC by specialty
• Adult Care Home Facility in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2011; 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.