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Alice Clark
Child Mental Illness Respite Care in Florence, Arizona
NPI 1063589299

Alice Clark is a Child Mental Illness Respite Care based in Florence, AZ and is specialized in Respite Care, Mental Illness, Child. Alice Clark practices in Florence, AZ. The NPI Number for Alice Clark is 1063589299 and holds a License No. 10784 (Arizona).

The current practice location address for Alice Clark is 10720 E. Marigold Lane, Florence, AZ and can be reached out via phone at 520-723-8228.

Location: 10720 E. Marigold Lane, Florence, AZ, 85232
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1063589299
Provider Name
Alice Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
10720 E. Marigold Lane, Florence, AZ, 85232
Phone Number
520-723-8228
Fax Number
Provider Enumeration Date
11/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
988321 01 AZ AHCCCS ID
institution
Provider Business Practice Location Address Details
Address
10720 E. Marigold Lane
City
Florence
State
Arizona
Zip
85232
Phone Number
520-723-8228
Fax Number
person
Provider Business Mailing Address Details
Address
10720 E. Marigold Lane
City
Florence
State
Arizona
Zip
85232
Phone Number
520-723-8228
Fax Number
person
Provider's Taxonomy Details 1
Type
Respite Care Facility
Classification
Respite Care
Speciality
Respite Care, Mental Illness, Child
Taxonomy
385HR2055X
License No.
10784 (Arizona)
Definition
A facility or distinct part of a facility that provides short term, residential care to children, diagnosed with mental illness, as respite for the regular caregivers.
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