NPIMap

Organization Active NPI

Clark Enterprises 407 LLC

  • In Home Supportive Care Agency
  • Decatur, IL
National Provider Identifier
1740432152
Registry record updated Oct 16, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
In Home Supportive Care AgencyTaxonomy code 253Z00000X
Legal business name
CLARK ENTERPRISES 407 LLC
Practice address
1398 N Oakland Ave
Decatur, IL 62526-3737
Phone
(217) 429-6666
Fax
(217) 429-3620
NPI assigned
Oct 16, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2008

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

Specialty (taxonomy)CodeLicenseStatePrimary
In Home Supportive Care Agency 253Z00000X IL Primary

Addresses

Primary practice location

1398 N Oakland Ave
Decatur, IL 62526-3737

Mailing address

1398 N Oakland Ave
Decatur, IL 62526-3737
Phone (217) 429-6666

Other names 1

  • Comfort Keepers Doing business as

National Provider Directory

National Provider Directory
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.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1224115200000",
    "number": "1740432152",
    "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": "2008-10-16",
        "last_updated": "2008-10-16",
        "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": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": "IL",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Comfort Keepers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.