CASONDRA CLARK – NPI #1558210658
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

CASONDRA CLARK is a community based residential treatment facility located in SURPRISE, AZ. NPPES has assigned the NPI number 1558210658 to CASONDRA CLARK on January 22, 2026. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 320900000X from the Health Care Provider Taxonomy code set, which is classified as Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities.

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for CASONDRA CLARK below.

NPI Profile for
CASONDRA CLARK

NPI Number
1558210658
Enumeration Date

(about 4 months ago)
Entity Type
Type-1  Individual (Female)
Legal Name
CASONDRA CLARK
Primary location
17874 W BLOOMFIELD RD
SURPRISE, AZ 85388-5619
Phone: (480) 465-2920 Fax:
Mailing address
Same as primary location
Sole Proprietor
Yes
Updated
Certification Date
Jan 22, 2026

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
320900000X
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.