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TEQUILA DIONTA CLARK
NPI 1427752245
Home Health in Florissant, MO

Active since March 27, 2023
1169 N HIGHWAY 67 ST, FLORISSANT, MO 63031(314) 733-5683(314) 733-5684 Get Directions Write a Review

NPPES record last updated: March 27, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Tequila Dionta Clark NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TEQUILA DIONTA CLARK (NPI 1427752245) is an individual home health provider in Florissant, Missouri and active in the NPI registry since March 2023.

NPPES Registry Identity

NPI1427752245
Entity TypeIndividualFemale
Primary Taxonomy251E00000X
Provider Legal NameTEQUILA DIONTA CLARK
Location Address1169 N HIGHWAY 67 STFlorissant, MO 63031-4701
Mailing Address2460 Center AveSaint Louis, MO 63136-3916 · (314) 393-7395 · Fax (314) 733-5684
Phone(314) 733-5683
Fax(314) 733-5684
Sole ProprietorYes
Enumeration DateMarch 27, 2023
NPPES CertifiedMarch 27, 2023
✔ NPI 1427752245 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyHome HealthAgencies
Taxonomy Code251E00000X
Definition
A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety.
1169 N HIGHWAY 67 ST, Florissant, MO 63031
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Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BUNDLES OF LOVE HOME HEALTH CARE LLC
Home Health
1169 N HIGHWAY 67 ST
FLORISSANT, MO 63031
St. Louis County (314) 733-5683

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tequila Clark's NPI number?

The NPI number for Tequila Clark is 1427752245. It was assigned to this individual provider in the NPPES registry on March 27, 2023.

Where is Tequila Clark located?

Tequila Clark practices at 1169 N Highway 67 St, Florissant, MO 63031. The listed phone number is (314) 733-5683.

What is Tequila Clark's specialty?

The primary specialty registered for this NPI is Home Health with taxonomy code 251E00000X.

When was this NPI record last updated?

The NPPES record for Tequila Clark was last updated on March 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.