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1184022303 NPI number — RENEWED HOPE COMMUNITY SERVICES INC.

NPI Number: 1184022303
Health Care Provider/Practitioner: RENEWED HOPE COMMUNITY SERVICES INC.

Information about “1184022303” NPI (RENEWED HOPE COMMUNITY SERVICES INC.) exists in 1184022303 in HTML format HTML  |  1184022303 in plain Text format TXT  |  1184022303 in PDF (Portable Document Format) PDF  |  1184022303 in an XML format XML  formats.

NPI Number : 1184022303 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1184022303",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RENEWED HOPE COMMUNITY 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": "626 E 71ST ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CHICAGO",
    "MailingAddressStateName": "IL",
    "MailingAddressPostalCode": "60619-1212",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "773-783-3579",
    "MailingAddressFaxNumber": "773-783-3592",
    "FirstLinePracticeLocationAddress": "626 E 71ST ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CHICAGO",
    "PracticeLocationAddressStateName": "IL",
    "PracticeLocationAddressPostalCode": "60619-1212",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "773-783-3579",
    "PracticeLocationAddressFaxNumber": "773-783-3592",
    "EnumerationDate": "12/22/2014",
    "LastUpdateDate": "07/19/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KUYE",
    "AuthorizedOfficialFirstName": "MICHAEL",
    "AuthorizedOfficialMiddleName": "IDOWU",
    "AuthorizedOfficialTitle": "EXEC. V/P OF OPERATIONS",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PH.D, LCSW, CRADC",
    "AuthorizedOfficialTelephoneNumber": "773-783-3579",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM2800X",
          "TaxonomyName": "Methadone Clinic",
          "LicenseNumber": "A-3536-0001-A",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0405X",
          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
          "LicenseNumber": "A-3536-0001-A",
          "LicenseNumberStateCode": "IL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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