National Provider Identifier Database

VICTOR CLARK
Assisted Living Facility

A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.


Contact Information

VICTOR CLARK
6352 W 13100 S
HERRIMAN, UT84096
Phone: 801-903-1040
Fax: 801-446-6293
Website:
Specialty Taxonomy Code
* Assisted Living Facility 310400000X

* Indicates primary specialty

NPI Profile & details for VICTOR CLARK

NPI Number 1649687948
Credentials
Entity Individual
Enumeration date 07/18/2014
Last updated 07/18/2014 - About 12 years ago
Sole proprietor1 Yes
Identifiers
  • UT License #: 2014-ALIIUT000651
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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