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1124698816 NPI number — SELECTIS WARRENTON LLC

NPI Number: 1124698816
Health Care Provider/Practitioner: SELECTIS WARRENTON LLC

Information about “1124698816” NPI (SELECTIS WARRENTON LLC) exists in 1124698816 in HTML format HTML  |  1124698816 in plain Text format TXT  |  1124698816 in PDF (Portable Document Format) PDF  |  1124698816 in an XML format XML  formats.

NPI Number : 1124698816 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124698816",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SELECTIS WARRENTON 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": "813 ATLANTA HWY",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WARRENTON",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30828-9105",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "706-465-3328",
    "MailingAddressFaxNumber": "706-465-1119",
    "FirstLinePracticeLocationAddress": "813 ATLANTA HWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WARRENTON",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30828-9105",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "706-465-3328",
    "PracticeLocationAddressFaxNumber": "706-465-1119",
    "EnumerationDate": "06/25/2021",
    "LastUpdateDate": "06/25/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "BARKER",
    "AuthorizedOfficialFirstName": "CHRISTOPHER",
    "AuthorizedOfficialMiddleName": "R",
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "303-449-2100",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "314000000X",
        "TaxonomyName": "Skilled Nursing Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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