NPIMap

Organization Active NPI

Clark Senior Care,Inc

  • Adult Care Home Facility
  • Calais, ME
National Provider Identifier
1659501534
Registry record updated Jul 25, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Care Home FacilityTaxonomy code 311ZA0620X
License
ALLS3154 Issued in ME
Legal business name
CLARK SENIOR CARE,INC
Practice address
526 South St
Calais, ME 04619-1118
Phone
(207) 454-3709
NPI assigned
Jul 25, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 25, 2009

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

Authorized official

Name
Judith A. Clark
Title
Owner/Administrator
Phone
(207) 454-3709

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Care Home Facility 311ZA0620X ALLS3154 ME Primary

Addresses

Primary practice location

526 South St
Calais, ME 04619-1118

Mailing address

526 South St
Calais, ME 04619-1118
Phone (207) 454-3709

Other identifiers 1

IdentifierTypeStateIssuer
131220001MedicaidME

National Provider Directory

National Provider Directory
Tax ID family
Clark Senior Care 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": "1248480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248480000000",
    "number": "1659501534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "526 SOUTH ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191118",
            "telephone_number": "207-454-3709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "526 SOUTH ST",
            "city": "CALAIS",
            "state": "ME",
            "postal_code": "046191118",
            "telephone_number": "207-454-3709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARK SENIOR CARE,INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-25",
        "last_updated": "2009-07-25",
        "status": "A",
        "authorized_official_last_name": "CLARK",
        "authorized_official_first_name": "JUDITH",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/ADMINISTRATOR",
        "authorized_official_telephone_number": "207-454-3709"
    },
    "taxonomies": [
        {
            "code": "311ZA0620X",
            "taxonomy_group": "",
            "desc": "Custodial Care Facility, Adult Care Home",
            "state": "ME",
            "license": "ALLS3154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "131220001",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Calais, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 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.