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1225511157 NPI number — MILLER & MOSS AFC

NPI Number: 1225511157
Health Care Provider/Practitioner: MILLER & MOSS AFC

Information about “1225511157” NPI (MILLER & MOSS AFC) exists in 1225511157 in HTML format HTML  |  1225511157 in plain Text format TXT  |  1225511157 in PDF (Portable Document Format) PDF  |  1225511157 in an XML format XML  formats.

NPI Number : 1225511157 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225511157",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MILLER & MOSS AFC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3409 IRENE ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "INKSTER",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48141-2124",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "734-721-9630",
    "MailingAddressFaxNumber": "734-895-8873",
    "FirstLinePracticeLocationAddress": "3638 IRENE ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "INKSTER",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48141-2127",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-405-0846",
    "PracticeLocationAddressFaxNumber": "734-895-8873",
    "EnumerationDate": "09/06/2018",
    "LastUpdateDate": "09/06/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MUHAMMAD",
    "AuthorizedOfficialFirstName": "CHARISE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VICE PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "313-758-8075",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": "AS820295801",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320900000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
          "LicenseNumber": "AS820295801",
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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