NPI Code Detail JSON Logo

1225497902 NPI number — FREEDOM FIRST SUPPORT SERVICES, LLC

NPI Number: 1225497902
Health Care Provider/Practitioner: FREEDOM FIRST SUPPORT SERVICES, LLC

Information about “1225497902” NPI (FREEDOM FIRST SUPPORT SERVICES, LLC) exists in 1225497902 in HTML format HTML  |  1225497902 in plain Text format TXT  |  1225497902 in PDF (Portable Document Format) PDF  |  1225497902 in an XML format XML  formats.

NPI Number : 1225497902 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225497902",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FREEDOM FIRST SUPPORT SERVICES, 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": "5 WARREN TER",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "WINSLOW",
    "MailingAddressStateName": "ME",
    "MailingAddressPostalCode": "04901-7612",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "207-649-1745",
    "MailingAddressFaxNumber": "207-861-7037",
    "FirstLinePracticeLocationAddress": "5 WARREN TER",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "WINSLOW",
    "PracticeLocationAddressStateName": "ME",
    "PracticeLocationAddressPostalCode": "04901-7612",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "207-649-1745",
    "PracticeLocationAddressFaxNumber": "207-861-7037",
    "EnumerationDate": "02/23/2016",
    "LastUpdateDate": "02/23/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "CHARTRAND",
    "AuthorizedOfficialFirstName": "TINA",
    "AuthorizedOfficialMiddleName": "MARIE",
    "AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "L.S.W.",
    "AuthorizedOfficialTelephoneNumber": "207-649-1745",
    "Taxonomies": {
      "Taxonomy": {
        "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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