Jessica Clarke
Individual provider Active NPI Assisted Living Facility · Black Mountain, NC
NPI 1699137141 · NPPES record last updated Oct 20, 2023
Key facts
- NPI
- 1699137141
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Assisted Living Facility 310400000X
- License
- FCL-011 (NC)
- Practice address
- 132 Center Ave
Black Mountain, NC 28711-3509 - Phone
- (910) 417-7351
- NPI assigned
- Mar 23, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| FCL-011 | NC | MD | Assisted Living Facility |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Assisted Living Facility | 310400000X | FCL-011 | NC | Yes |
Addresses
Primary practice location
132 Center Ave
Black Mountain, NC 28711-3509
Mailing address
PO Box 897
Black Mountain, NC 28711-0897
Phone (910) 417-7351
Other providers in Black Mountain, NC
- Jonathan Erik Chaplinsky
- Cheri Lisa Holmes
- Deirdre Schoen Christy
- Paul G Clark
- Ryan Radwin Clark
- Stephanie Clements
- Gena Cohen
- Cold Mountain Pharmacy Services
- Cold Mountain Pharmacy Services
- Cold Mountain Pharmacy Services L.L.C.
All providers in Black Mountain, NC · Assisted Living Facility in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 20, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.