NPI Code Detail JSON Logo

1265889653 NPI number — AMERICAN CTR FOR INTELLECTUAL AND DEV. DISABILITIES IN MD, INC.

NPI Number: 1265889653
Health Care Provider/Practitioner: AMERICAN CTR FOR INTELLECTUAL AND DEV. DISABILITIES IN MD, INC.

Information about “1265889653” NPI (AMERICAN CTR FOR INTELLECTUAL AND DEV. DISABILITIES IN MD, INC.) exists in 1265889653 in HTML format HTML  |  1265889653 in plain Text format TXT  |  1265889653 in PDF (Portable Document Format) PDF  |  1265889653 in an XML format XML  formats.

NPI Number : 1265889653 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265889653",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AMERICAN CTR FOR INTELLECTUAL AND DEV. DISABILITIES IN MD, INC.",
    "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": "5999 HARPERS FARM RD",
    "SecondLineMailingAddress": "SUITE E-250",
    "MailingAddressCityName": "COLUMBIA",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21044-3013",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "443-319-5010",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "5999 HARPERS FARM RD",
    "SecondLinePracticeLocationAddress": "SUITE E-250",
    "PracticeLocationAddressCityName": "COLUMBIA",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21044-3013",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "443-319-5010",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/16/2016",
    "LastUpdateDate": "05/16/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MATHEW",
    "AuthorizedOfficialFirstName": "JOSEPH",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PH.D",
    "AuthorizedOfficialTelephoneNumber": "443-319-5010",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": "MH-1963 & 1964",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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