NPI Code Detail JSON Logo

1124807896 NPI number — MAIDEN'S EMBRACE ABA

NPI Number: 1124807896
Health Care Provider/Practitioner: MAIDEN'S EMBRACE ABA

Information about “1124807896” NPI (MAIDEN'S EMBRACE ABA) exists in 1124807896 in HTML format HTML  |  1124807896 in plain Text format TXT  |  1124807896 in PDF (Portable Document Format) PDF  |  1124807896 in an XML format XML  formats.

NPI Number : 1124807896 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1124807896",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MAIDEN'S EMBRACE ABA",
    "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": "10985 PACIFIC POINT PL UNIT 1203",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SAN DIEGO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92129-2088",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "858-253-0809",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10985 PACIFIC POINT PL UNIT 1203",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN DIEGO",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92129-2088",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "858-253-0809",
    "PracticeLocationAddressFaxNumber": "858-261-0057",
    "EnumerationDate": "09/22/2023",
    "LastUpdateDate": "05/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GRADY",
    "AuthorizedOfficialFirstName": "IFAH",
    "AuthorizedOfficialMiddleName": "S",
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "BCBA",
    "AuthorizedOfficialTelephoneNumber": "858-253-0809",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251E00000X",
          "TaxonomyName": "Home Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251V00000X",
          "TaxonomyName": "Voluntary or Charitable Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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