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1104119239 NPI number — EXCELLENT SERVICES OF KENTUCKY LLC

NPI Number: 1104119239
Health Care Provider/Practitioner: EXCELLENT SERVICES OF KENTUCKY LLC

Information about “1104119239” NPI (EXCELLENT SERVICES OF KENTUCKY LLC) exists in 1104119239 in HTML format HTML  |  1104119239 in plain Text format TXT  |  1104119239 in PDF (Portable Document Format) PDF  |  1104119239 in an XML format XML  formats.

NPI Number : 1104119239 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104119239",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EXCELLENT SERVICES OF KENTUCKY LLC",
    "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": "4965 US HIGHWAY 42",
    "SecondLineMailingAddress": "SUITE 1000",
    "MailingAddressCityName": "LOUISVILLE",
    "MailingAddressStateName": "KY",
    "MailingAddressPostalCode": "40222-6372",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "888-774-0767",
    "MailingAddressFaxNumber": "888-774-8022",
    "FirstLinePracticeLocationAddress": "4965 US HIGHWAY 42",
    "SecondLinePracticeLocationAddress": "SUITE 1000",
    "PracticeLocationAddressCityName": "LOUISVILLE",
    "PracticeLocationAddressStateName": "KY",
    "PracticeLocationAddressPostalCode": "40222-6372",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "888-774-0767",
    "PracticeLocationAddressFaxNumber": "888-774-8022",
    "EnumerationDate": "05/23/2011",
    "LastUpdateDate": "05/23/2011",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "WESTON",
    "AuthorizedOfficialFirstName": "JOHN",
    "AuthorizedOfficialMiddleName": "H",
    "AuthorizedOfficialTitle": "CHAIRMAN OF THE BOARD",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": "JR.",
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "317-557-6430",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251C00000X",
        "TaxonomyName": "Developmentally Disabled Services Day Training Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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