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1053626184 NPI number — MOTHER GOLDEN YEARS III

NPI Number: 1053626184
Health Care Provider/Practitioner: MOTHER GOLDEN YEARS III

Information about “1053626184” NPI (MOTHER GOLDEN YEARS III) exists in 1053626184 in HTML format HTML  |  1053626184 in plain Text format TXT  |  1053626184 in PDF (Portable Document Format) PDF  |  1053626184 in an XML format XML  formats.

NPI Number : 1053626184 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053626184",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MOTHER GOLDEN YEARS III",
    "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": "13621 SW 281ST TER",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "HOMESTEAD",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33033-1931",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "305-225-1289",
    "MailingAddressFaxNumber": "305-225-1289",
    "FirstLinePracticeLocationAddress": "13621 SW 281ST TER",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "HOMESTEAD",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33033-1931",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "305-225-1289",
    "PracticeLocationAddressFaxNumber": "305-225-1289",
    "EnumerationDate": "08/12/2010",
    "LastUpdateDate": "08/12/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MARTINEZ",
    "AuthorizedOfficialFirstName": "AMALIA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "305-225-7119",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "310400000X",
        "TaxonomyName": "Assisted Living Facility",
        "LicenseNumber": "AL11055",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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