Carr, Jack Clifford
Carr, Jack Clifford is an sole proprietor health care provider with primary practice located at 7232 Justin Way , Mentor OH 44060-4881. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Behavioral Health & Social Service Providers / Counselor. Other Service Providers / Case Manager/Care Coordinator is his primary health care specialty. Carr, Jack Clifford can be contacted via phone (440) 578-8200.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X | ||
| Behavioral Health & Social Service Providers / Counselor | 101Y00000X |
Profile Details
| NPI number | 1174037774 |
|---|---|
| LBN Legal business name | Carr, Jack Clifford |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 20th, 2017 |
| Last updated | Apr 2nd, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174037774 | NPPES |
| Ohio | MEDICAID | 0306392 |
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