NPI 1972958106

Shanell Clark

Practitioner Nursing Home Administrator Oak Park, MI

Practice location

Address: 21820 Beverly St, Oak Park, MI 48237-2503
Phone: (248) 234-6150

Registered specialties (4)

Nursing Home Administrator Primary

Nursing Service Related Providers Taxonomy 376G00000X

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Case Manager/Care Coordinator

Other Service Providers Taxonomy 171M00000X

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Chore Provider

Nursing Service Related Providers Taxonomy 372500000X

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Day Training/Habilitation Specialist

Nursing Service Related Providers Taxonomy 373H00000X

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Registry record

NPI: 1972958106
Entity type: Individual
Sex (as registered): Female
NPI issued: 25 Apr 2016
Record last updated: 25 Apr 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.