NPI Code Detail JSON Logo

1144041328 NPI number — SOLACE GROVE ASSISTED LIVING LLC

NPI Number: 1144041328
Health Care Provider/Practitioner: SOLACE GROVE ASSISTED LIVING LLC

Information about “1144041328” NPI (SOLACE GROVE ASSISTED LIVING LLC) exists in 1144041328 in HTML format HTML  |  1144041328 in plain Text format TXT  |  1144041328 in PDF (Portable Document Format) PDF  |  1144041328 in an XML format XML  formats.

NPI Number : 1144041328 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1144041328",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOLACE GROVE ASSISTED LIVING 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": "1880 HOWARD AVE STE 301A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "VIENNA",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22182-2611",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "38685 GOOSE CREEK LN",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LEESBURG",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "20175-6642",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-462-9141",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/21/2024",
    "LastUpdateDate": "10/21/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JUMA",
    "AuthorizedOfficialFirstName": "IBRAHIM",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "814-423-0387",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "3104A0625X",
          "TaxonomyName": "Assisted Living Facility (Mental Illness)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3104A0630X",
          "TaxonomyName": "Assisted Living Facility (Behavioral Disturbances)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "310400000X",
          "TaxonomyName": "Assisted Living Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.