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1295059392 NPI number — PEREGRINE CARE, LLC

NPI Number: 1295059392
Health Care Provider/Practitioner: PEREGRINE CARE, LLC

Information about “1295059392” NPI (PEREGRINE CARE, LLC) exists in 1295059392 in HTML format HTML  |  1295059392 in plain Text format TXT  |  1295059392 in PDF (Portable Document Format) PDF  |  1295059392 in an XML format XML  formats.

NPI Number : 1295059392 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1295059392",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PEREGRINE CARE, 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": "24400 WALNUT ST",
    "SecondLineMailingAddress": "SUITE E",
    "MailingAddressCityName": "NEWHALL",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "91321-2850",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "661-254-8701",
    "MailingAddressFaxNumber": "661-254-8703",
    "FirstLinePracticeLocationAddress": "24400 WALNUT ST",
    "SecondLinePracticeLocationAddress": "SUITE E",
    "PracticeLocationAddressCityName": "NEWHALL",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "91321-2850",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "661-254-8701",
    "PracticeLocationAddressFaxNumber": "661-254-8703",
    "EnumerationDate": "03/17/2010",
    "LastUpdateDate": "03/17/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PERRONE",
    "AuthorizedOfficialFirstName": "CHARLENE",
    "AuthorizedOfficialMiddleName": "PAMELA",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "CSA",
    "AuthorizedOfficialTelephoneNumber": "661-254-8701",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "253Z00000X",
        "TaxonomyName": "In Home Supportive Care Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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