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CASONDRA CLARK
NPI 1558210658
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Surprise, AZ

Active since January 22, 2026
17874 W BLOOMFIELD RD, SURPRISE, AZ 85388(480) 465-2920 Get Directions Write a Review

NPPES record last updated: January 22, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Casondra Clark NPPES

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

CASONDRA CLARK (NPI 1558210658) is an individual community based residential treatment facility, intellectual and/or developmental disabilities provider in Surprise, Arizona and active in the NPI registry since January 2026.

NPPES Registry Identity

NPI1558210658
Entity TypeIndividualFemale
Primary Taxonomy320900000X
Provider Legal NameCASONDRA CLARK
Location Address17874 W BLOOMFIELD RDSurprise, AZ 85388-5619
Mailing Address17874 W Bloomfield RdSurprise, AZ 85388-5619
Phone(480) 465-2920
Sole ProprietorYes
Enumeration DateJanuary 22, 2026
NPPES CertifiedJanuary 22, 2026
✔ NPI 1558210658 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCommunity Based Residential Treatment Facility, Intellectual and/or Developmental DisabilitiesResidential Treatment Facilities
Taxonomy Code320900000X
Definition
A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities.
17874 W BLOOMFIELD RD, Surprise, AZ 85388
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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 Casondra Clark's NPI number?

The NPI number for Casondra Clark is 1558210658. It was assigned to this individual provider in the NPPES registry on January 22, 2026.

Where is Casondra Clark located?

Casondra Clark practices at 17874 W Bloomfield Rd, Surprise, AZ 85388. The listed phone number is (480) 465-2920.

What is Casondra Clark's specialty?

The primary specialty registered for this NPI is Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities with taxonomy code 320900000X.

When was this NPI record last updated?

The NPPES record for Casondra Clark was last updated on January 22, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 months 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.