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Search › Michigan › 376G00000X

Shanell Clark

NPI 1972958106 · on the registry since 2016 · sole proprietor

Practice

Address
21820 Beverly St
Oak Park, MI 48237
Phone
(248) 234-6150
Organisation at this address
Fountain Of Love Assisted Living Inc
Fountain Of Love Assisted Living Sevices Inc
Inferred from a shared address, not stated in the registry.

Registry record

Primary taxonomy
376G00000X
376G00000X
Also registered as
171M00000X
372500000X
373H00000X
Sex
Female
Record last updated
2016-04-25

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan