TRINETTE CLARK (NPI# 1750791786) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750791786 |
| Entity Type | Individual |
| Full Name | TRINETTE CLARK |
| Practice Address |
3246 Orchard Ave Indianapolis IN 46218-1937 |
| Practice Telephone | 3176570670 |
| Mailing Telephone | 3176570670 |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2019-07-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 246RP1900X |
Technician, Pathology Specialization: Phlebotomy |
5560 | IL | Technologists, Technicians & Other Technical Service Providers |
| Y | 385HR2055X |
Respite Care Specialization: Respite Care, Mental Illness, Child |
IN | Respite Care Facility |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 6252 N Lee St, #54, Morrow, GA 302601266 | 8638455319 |
| Street Address |
3246 ORCHARD AVE |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46218-1937 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487208930 | Darryl K Webster | Counselor | 4901 E. 31st Street, Indianapolis, IN 46218 | 2019-08-01 |
| 1780238238 | Rhonda Y. Battles | Counselor | 1775 N Sherman Dr Suite A, Indianapolis, IN 46218 | 2019-08-01 |
| 1861918849 | Corey Simmons | Ambulance | 3659 N Temple Ave, Indianapolis, IN 46218 | 2017-08-21 |
| 1245769645 | Community Health Network, Inc | Clinic/Center | 1640 N. Ritter Avenue, Indianapolis, IN 46218 | 2017-06-08 |
| 1912221615 | Melvin Lowell Stringer Jr. | Driver | 3266 N. Arsenal Ave, Indianapolis, IN 46218 | 2010-03-24 |
| 1952523854 | Allyson Leigh Mcintire | Counselor | 5502 E 16 Th Street, Indpls, IN 46218 | 2007-05-02 |
| 1104912963 | Andrea Sue Campbell | Social Worker | 5502 E 16th Street, Indpls, IN 46218 | 2006-10-05 |
| 1720186356 | Abbie Ann Grudzien | Counselor | 4701 N Keystone, Ste 150, Indpls, IN 46218 | 2006-09-20 |
| 1508978784 | Linda A Fundenberger | Ophthalmology | 2815 E 38th Street, Indianapolis, IN 46218 | 2006-08-31 |
| 1063467850 | Aaron P Kalinowski | Emergency Medicine | 2920 N Arlington Ave Ste B, Indianapolis, IN 46218 | 2006-05-23 |
| Find all providers in zip 46218 | ||||
| Taxonomy Code | 385HR2055X |
| Grouping | Respite Care Facility |
| Classification | Respite Care |
| Specialization | Respite Care, Mental Illness, Child |
| 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. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396046736 | Vigo County Homes for Children | Respite Care | 1308 S 6th St, Terre Haute, IN 47802-1112 | 2010-11-16 |
| 1386713279 | Gibault, Inc. | Respite Care | 6301 S Us Hwy 41, Terre Haute, IN 47802-0316 | 2006-11-07 |
| 1689172462 | Denicka Foster | Respite Care | 53211 Kinglet Ln, South Bend, IN 46637-5112 | 2018-01-26 |
| City | INDIANAPOLIS |
| Zip Code | 46218 |
Please comment or provide details below to improve the information on TRINETTE CLARK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.