Demetria Clark is a Emotionally Disturbed Childrens' Residential Treatment Facility based in Toledo, OH. Demetria Clark practices in Toledo, OH. The NPI Number for Demetria Clark is 1487209722 and holds a License No. (Ohio).
The current practice location address for Demetria Clark is 709 Lodge Ave, Toledo, OH and can be reached out via phone at 567-702-1078.
Location: 709 Lodge Ave, Toledo, OH, 43609-1173
Provider Profile Details
NPI Number
1487209722
Provider Name
Demetria Clark
Credential
Provider Entity Type
Individual
Gender
Female
Address
709 Lodge Ave, Toledo, OH, 43609-1173
Phone Number
567-702-1078
Fax Number
Provider Enumeration Date
08/05/2019
Last Update Date
03/10/2024
Provider Business Practice Location Address Details
Address
709 Lodge Ave
City
State
Zip
43609-2915
Phone Number
567-702-1078
Fax Number
Provider Business Mailing Address Details
Address
709 Lodge Ave
City
State
Zip
43609-2915
Phone Number
567-702-1078
Fax Number
Provider's Taxonomy Details 1
Type
Technologists, Technicians & Other Technical Service Providers
Classification
Technician, Other
Speciality
-
Taxonomy
License No.
()
Definition
A collective term for persons with specialized training in various narrow fields of expertise whose occupations require training and skills in specific technical processes and procedures; and where further classification is deemed unnecessary by the user.
Provider's Taxonomy Details 2
Type
Agencies
Classification
Home Health
Speciality
-
Taxonomy
License No.
()
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.
Provider's Taxonomy Details 3
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Adult Day Care
Taxonomy
License No.
()
Definition
Definition to come...
Provider's Taxonomy Details 4
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
Provider's Taxonomy Details 5
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Emotionally Disturbed Children
Speciality
-
Taxonomy
License No.
()
Definition
A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
Provider's Taxonomy Details 6
Type
Transportation Services
Classification
Secured Medical Transport (VAN)
Speciality
-
Taxonomy
License No.
()
Definition
A public or privately owned transportation service with vehicles, specially equipped to provide enhanced safety, security and passenger restraint, and staffed by one or more individuals trained to work with patients in crisis situations resulting from mental or emotional illness and/or substance abuse.
Provider's Taxonomy Details 7
Type
Transportation Services
Classification
Non-emergency Medical Transport (VAN)
Speciality
-
Taxonomy
License No.
()
Definition
A land vehicle with a capacity to meet special height, clearance, access, and seating, for the conveyance of persons in non-emergency situations. The vehicle may or may not be required to meet local county or state regulations.
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