JOE CLARK RESIDENTIAL CARE HOME
NPI 1316369192
Assisted Living Facility in Nevada, MO
- Organization
- Assisted Living Facility
About JOE CLARK RESIDENTIAL CARE HOME
This page provides the complete NPI Profile along with additional information for Joe Clark Residential Care Home, a provider established in Nevada, Missouri operating as a Assisted Living Facility. The healthcare provider is registered in the NPI registry with number 1316369192 assigned on January 2014. The practitioner's primary taxonomy code is 310400000X with license number 041597 (MO). The provider is registered as an organization and their NPI record was last updated 13 years ago. The provider's is doing business as Joe Clark Residential Care Home. The authorized official of this NPI record is Ms. Karen Clark (Managing Member)
- NPI
- 1316369192 Verify this NPI
- Provider Legal Name
- KRC 1495 HEALTH CARE SERVICES LLC
- Other Organization Name
- JOE CLARK RESIDENTIAL CARE HOME
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1495 E ASHLAND ST NEVADA, MO 64772
- Location Phone
- (417) 667-5000
- Mailing Address
- PO BOX 246 NEVADA, MO 64772
- Mailing Phone
- (417) 667-5000
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-13-2014
- Last Update Date
- 01-13-2014
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Assisted Living Facility
- Taxonomy Code
- 310400000X
- Type
- Nursing & Custodial Care Facilities
- License No.
- 041597
- License State
- MO
- Taxonomy Description
- 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.
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Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1316369192, enumerated as an "organization" on January 13, 2014.
The provider is located at 1495 E ASHLAND ST NEVADA, MO 64772 and the phone number is (417) 667-5000.
Assisted Living Facility with taxonomy code 310400000X.
