Provider Demographics
NPI:1386075596
Name:CLEMENS HOME CARE
Entity type:Organization
Organization Name:CLEMENS HOME CARE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:
Authorized Official - Last Name:CLEMENS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:205-409-4677
Mailing Address - Street 1:525 ENERGY CENTER BLVD STE 1602
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35473-5831
Mailing Address - Country:US
Mailing Address - Phone:205-409-4677
Mailing Address - Fax:
Practice Address - Street 1:525 ENERGY CENTER BLVD STE 1602
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35473-5831
Practice Address - Country:US
Practice Address - Phone:205-409-4677
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health