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1174970719 NPI number — EDGEWOOD CENTER FOR CHILDREN & FAMILIES

NPI Number: 1174970719
Health Care Provider/Practitioner: EDGEWOOD CENTER FOR CHILDREN & FAMILIES

Information about “1174970719” NPI (EDGEWOOD CENTER FOR CHILDREN & FAMILIES) exists in 1174970719 in HTML format HTML  |  1174970719 in plain Text format TXT  |  1174970719 in PDF (Portable Document Format) PDF  |  1174970719 in an XML format XML  formats.

NPI Number : 1174970719 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1174970719",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "EDGEWOOD CENTER FOR CHILDREN & FAMILIES",
    "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": "170 NORTHRIDGE DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DALY CITY",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "94015-4618",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "415-994-7410",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "170 NORTHRIDGE DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DALY CITY",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "94015-4618",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "415-994-7410",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/24/2016",
    "LastUpdateDate": "05/24/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "RAY",
    "AuthorizedOfficialFirstName": "THERESA",
    "AuthorizedOfficialMiddleName": "D",
    "AuthorizedOfficialTitle": "CHILD CARE COUNSELOR",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MBA/PA",
    "AuthorizedOfficialTelephoneNumber": "415-994-7410",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "322D00000X",
        "TaxonomyName": "Emotionally Disturbed Childrens' Residential Treatment Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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