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1053161943 NPI number — FRETUS INVESTORS GLENDALE, LLC

NPI Number: 1053161943
Health Care Provider/Practitioner: FRETUS INVESTORS GLENDALE, LLC

Information about “1053161943” NPI (FRETUS INVESTORS GLENDALE, LLC) exists in 1053161943 in HTML format HTML  |  1053161943 in plain Text format TXT  |  1053161943 in PDF (Portable Document Format) PDF  |  1053161943 in an XML format XML  formats.

NPI Number : 1053161943 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053161943",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FRETUS INVESTORS GLENDALE, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5861 W BEVERLY LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GLENDALE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85306-1804",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "602-938-7166",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5861 W BEVERLY LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GLENDALE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85306-1804",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "602-938-7166",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/25/2024",
    "LastUpdateDate": "04/04/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MUNOZ",
    "AuthorizedOfficialFirstName": "ANNA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "ASSISTANT SECRETARY",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "414-918-5443",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "310400000X",
        "TaxonomyName": "Assisted Living Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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