Provider Demographics
NPI:1811449432
Name:CLARK SENIOR CARE, INC
Entity type:Organization
Organization Name:CLARK SENIOR CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:HIGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:207-214-3300
Mailing Address - Street 1:526 SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:CALAIS
Mailing Address - State:ME
Mailing Address - Zip Code:04619-1118
Mailing Address - Country:US
Mailing Address - Phone:207-454-3709
Mailing Address - Fax:207-454-1141
Practice Address - Street 1:526 SOUTH ST
Practice Address - Street 2:
Practice Address - City:CALAIS
Practice Address - State:ME
Practice Address - Zip Code:04619-1118
Practice Address - Country:US
Practice Address - Phone:207-454-3709
Practice Address - Fax:207-454-1141
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-31
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes310400000XNursing & Custodial Care FacilitiesAssisted Living Facility