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1154954725 NPI number — GRACE AUTISM SERVICES INC

NPI Number: 1154954725
Health Care Provider/Practitioner: GRACE AUTISM SERVICES INC

Information about “1154954725” NPI (GRACE AUTISM SERVICES INC) exists in 1154954725 in HTML format HTML  |  1154954725 in plain Text format TXT  |  1154954725 in PDF (Portable Document Format) PDF  |  1154954725 in an XML format XML  formats.

NPI Number : 1154954725 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1154954725",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GRACE AUTISM SERVICES INC",
    "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": "1 DIAMOND CAUSEWAY",
    "SecondLineMailingAddress": "SUITE 21 - 121",
    "MailingAddressCityName": "SAVANNAH",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31406-9515",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "912-434-4343",
    "MailingAddressFaxNumber": "912-452-9600",
    "FirstLinePracticeLocationAddress": "1481 DEAN FOREST RD # BUILD100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAVANNAH",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31405-9342",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "912-434-4343",
    "PracticeLocationAddressFaxNumber": "912-452-9600",
    "EnumerationDate": "02/21/2020",
    "LastUpdateDate": "01/03/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "OWENS",
    "AuthorizedOfficialFirstName": "AMANDA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO / OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "912-434-4343",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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