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1063834166 NPI number — ALIVE AND WELL RECOVERY CENTER

NPI Number: 1063834166
Health Care Provider/Practitioner: ALIVE AND WELL RECOVERY CENTER

Information about “1063834166” NPI (ALIVE AND WELL RECOVERY CENTER) exists in 1063834166 in HTML format HTML  |  1063834166 in plain Text format TXT  |  1063834166 in PDF (Portable Document Format) PDF  |  1063834166 in an XML format XML  formats.

NPI Number : 1063834166 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1063834166",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ALIVE AND WELL RECOVERY CENTER",
    "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": "204 S MAIN ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KELLER",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76248-7034",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "817-944-7871",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "204 S MAIN ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "KELLER",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76248-7034",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-944-7871",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/09/2014",
    "LastUpdateDate": "01/09/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FRONTZ",
    "AuthorizedOfficialFirstName": "JOIE",
    "AuthorizedOfficialMiddleName": "LYNNE",
    "AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PRSS",
    "AuthorizedOfficialTelephoneNumber": "817-944-7871",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "TX",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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