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1285053553 NPI number — ENRICHMENT SUPPORT SERVICES, LLC

NPI Number: 1285053553
Health Care Provider/Practitioner: ENRICHMENT SUPPORT SERVICES, LLC

Information about “1285053553” NPI (ENRICHMENT SUPPORT SERVICES, LLC) exists in 1285053553 in HTML format HTML  |  1285053553 in plain Text format TXT  |  1285053553 in PDF (Portable Document Format) PDF  |  1285053553 in an XML format XML  formats.

NPI Number : 1285053553 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1285053553",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ENRICHMENT SUPPORT SERVICES, LLC",
    "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": "3300 ONYX RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIRAMAR",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33025-2821",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "954-257-7394",
    "MailingAddressFaxNumber": "954-251-0562",
    "FirstLinePracticeLocationAddress": "701 PROMENADE DR",
    "SecondLinePracticeLocationAddress": "SUITE 204",
    "PracticeLocationAddressCityName": "PEMBROKE PINES",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33026-6034",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "954-364-8842",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/15/2014",
    "LastUpdateDate": "04/15/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DANIEL",
    "AuthorizedOfficialFirstName": "ANSE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "SOLE PROPRIETOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LMFT",
    "AuthorizedOfficialTelephoneNumber": "954-257-7394",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": "L14000040502",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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