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1013537802 NPI number — GRETCHEN'S PLACE

NPI Number: 1013537802
Health Care Provider/Practitioner: GRETCHEN'S PLACE

Information about “1013537802” NPI (GRETCHEN'S PLACE) exists in 1013537802 in HTML format HTML  |  1013537802 in plain Text format TXT  |  1013537802 in PDF (Portable Document Format) PDF  |  1013537802 in an XML format XML  formats.

NPI Number : 1013537802 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1013537802",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GRETCHEN'S PLACE",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "46036 MICHIGAN AVE # 318",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CANTON",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48188-2304",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "25 OWEN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BELLEVILLE",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48111-2921",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-699-5400",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/21/2020",
    "LastUpdateDate": "08/12/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HILL",
    "AuthorizedOfficialFirstName": "DEODGE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PA",
    "AuthorizedOfficialTelephoneNumber": "734-699-5400",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QP2300X",
          "TaxonomyName": "Primary Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM1300X",
          "TaxonomyName": "Multi-Specialty Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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