Doctor Name: | JESSICA CLARKE |
NPI Number: | 1699137141 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | FCL-011 |
Business Practice Address: | 132 Center Ave Black Mountain, NC - 287113509 |
Business Phone Number: | 9104177351 |
Business Fax Number: | |
Mailing Address: | 108 Meadow Creek Ln, ETOWAH |
State: | NC |
Postal Code: | 287298807 |
Phone Number: | 9104177351 |
Fax Number: | |
NPI Enumeration Date: | 03/23/2016 |
NPI Last Update Date: | 03/23/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 310400000X |
License Number: | FCL-011 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NC |
Taxonomy Type: | Nursing & Custodial Care Facilities |
Taxonomy Classification: | Assisted Living Facility |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being. |