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1174451058 NPI number — COUP DE MAIN

NPI Number: 1174451058
Health Care Provider/Practitioner: COUP DE MAIN

Information about “1174451058” NPI (COUP DE MAIN) exists in 1174451058 in HTML format HTML  |  1174451058 in plain Text format TXT  |  1174451058 in PDF (Portable Document Format) PDF  |  1174451058 in an XML format XML  formats.

NPI Number : 1174451058 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174451058",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "COUP DE MAIN",
    "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": "1624 PLAIN AVE NE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CANTON",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44714-2346",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "330-224-7560",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1624 PLAIN AVE NE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CANTON",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44714-2346",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "330-224-7560",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/12/2026",
    "LastUpdateDate": "05/12/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MCCOLLUM-DOTSON",
    "AuthorizedOfficialFirstName": "WANDA",
    "AuthorizedOfficialMiddleName": "JO",
    "AuthorizedOfficialTitle": "DIRECTOR OF OPERATION",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "330-224-7560",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "343900000X",
          "TaxonomyName": "Non-emergency Medical Transport (VAN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385H00000X",
          "TaxonomyName": "Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2060X",
          "TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320900000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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