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1104362631 NPI number — ABUNDANT NURSING CARE

NPI Number: 1104362631
Health Care Provider/Practitioner: ABUNDANT NURSING CARE

Information about “1104362631” NPI (ABUNDANT NURSING CARE) exists in 1104362631 in HTML format HTML  |  1104362631 in plain Text format TXT  |  1104362631 in PDF (Portable Document Format) PDF  |  1104362631 in an XML format XML  formats.

NPI Number : 1104362631 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104362631",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ABUNDANT NURSING CARE",
    "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": "445 LAFAYETTE AVE.",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAYETTEVILLE",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30214",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "601-421-2022",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "6230 TANGLEWOOD DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSON",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "39213-7937",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "601-421-2022",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/08/2017",
    "LastUpdateDate": "01/08/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BROWN",
    "AuthorizedOfficialFirstName": "LASHELIA",
    "AuthorizedOfficialMiddleName": "SHANTA",
    "AuthorizedOfficialTitle": "CEO, ADMINISTRATIVE DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "407-304-6419",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251E00000X",
        "TaxonomyName": "Home Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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