Healthcare Provider Details

I. General information

NPI: 1831006352
Provider Name (Legal Business Name): RACHEL CLARKE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1121 M ST SUITE 110
LINCOLN NE
68508
US

IV. Provider business mailing address

1121 M ST SUITE 110
LINCOLN NE
68508
US

V. Phone/Fax

Practice location:
  • Phone: 402-904-4216
  • Fax:
Mailing address:
  • Phone: 402-904-4216
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: