1114793387 NPI number — AAA PATRIOT CARE ALLIANCE HEALTHCARE AGENCY INC.

NPI Number: 1114793387
Health Care Provider/Practitioner: AAA PATRIOT CARE ALLIANCE HEALTHCARE AGENCY INC.

NPI Number : 1114793387 – JSON Data Format

                
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    "NPI": "1114793387",
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    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AAA PATRIOT CARE ALLIANCE HEALTHCARE AGENCY INC.",
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    "FirstLineMailingAddress": "1239 W CASTLE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CASA GRANDE",
    "MailingAddressStateName": "AZ",
    "MailingAddressPostalCode": "85122-6652",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "520-518-0844",
    "MailingAddressFaxNumber": "888-335-2493",
    "FirstLinePracticeLocationAddress": "1239 W CASTLE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CASA GRANDE",
    "PracticeLocationAddressStateName": "AZ",
    "PracticeLocationAddressPostalCode": "85122-6652",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "520-518-0844",
    "PracticeLocationAddressFaxNumber": "888-335-2493",
    "EnumerationDate": "11/29/2023",
    "LastUpdateDate": "12/18/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JEFFERSON",
    "AuthorizedOfficialFirstName": "PATRICIA",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "FOUNDER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "520-518-0844",
    "Taxonomies": {
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    "HealthcareProviderTaxonomyGroups": null
  }
}