Healthcare Provider Details

I. General information

NPI: 1013839893
Provider Name (Legal Business Name): CARTALE CLARK LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2749 PRESCOTT DOWNS
STOW OH
44224-6224
US

IV. Provider business mailing address

2749 PRESCOTT DOWNS
STOW OH
44224-6224
US

V. Phone/Fax

Practice location:
  • Phone: 330-510-6082
  • Fax:
Mailing address:
  • Phone: 330-510-6082
  • 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
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: CARTALE CLARK
Title or Position: CEO
Credential:
Phone: 330-510-6082