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1154752178 NPI number — QUAIL MEADOW ASSISTED LIVING, LLC

NPI Number: 1154752178
Health Care Provider/Practitioner: QUAIL MEADOW ASSISTED LIVING, LLC

Information about “1154752178” NPI (QUAIL MEADOW ASSISTED LIVING, LLC) exists in 1154752178 in HTML format HTML  |  1154752178 in plain Text format TXT  |  1154752178 in PDF (Portable Document Format) PDF  |  1154752178 in an XML format XML  formats.

NPI Number : 1154752178 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154752178",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "QUAIL MEADOW 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": "786 E 2100 N",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORTH OGDEN",
    "MailingAddressStateName": "UT",
    "MailingAddressPostalCode": "84414-2935",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "801-782-7440",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "786 E 2100 N",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORTH OGDEN",
    "PracticeLocationAddressStateName": "UT",
    "PracticeLocationAddressPostalCode": "84414-2935",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "801-782-7440",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/01/2013",
    "LastUpdateDate": "03/21/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MARTZ",
    "AuthorizedOfficialFirstName": "ERIC",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "801-866-5009",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "310400000X",
        "TaxonomyName": "Assisted Living Facility",
        "LicenseNumber": "2013-ALII-UT000615",
        "LicenseNumberStateCode": "UT",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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