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1316452501 NPI number — PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC

NPI Number: 1316452501
Health Care Provider/Practitioner: PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC

Information about “1316452501” NPI (PROFESSIONAL STAFFING SOLUTIONS ADULT DAY SERVICES, LLC) exists in 1316452501 in HTML format HTML  |  1316452501 in plain Text format TXT  |  1316452501 in PDF (Portable Document Format) PDF  |  1316452501 in an XML format XML  formats.

NPI Number : 1316452501 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1316452501",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROFESSIONAL STAFFING SOLUTIONS ADULT DAY 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": "PO BOX 4580",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "GREENVILLE",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38704-4580",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-335-5554",
    "MailingAddressFaxNumber": "662-335-5580",
    "FirstLinePracticeLocationAddress": "1633 BROADWAY EXT N # P",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "GREENVILLE",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38703-1942",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-335-5554",
    "PracticeLocationAddressFaxNumber": "662-335-5580",
    "EnumerationDate": "12/09/2017",
    "LastUpdateDate": "05/09/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "REDMOND",
    "AuthorizedOfficialFirstName": "PANDORA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN",
    "AuthorizedOfficialTelephoneNumber": "662-822-1924",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "372600000X",
          "TaxonomyName": "Adult Companion",
          "LicenseNumber": "R863014",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "376J00000X",
          "TaxonomyName": "Homemaker",
          "LicenseNumber": "R863014",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QA0600X",
          "TaxonomyName": "Adult Day Care Clinic/Center",
          "LicenseNumber": "R863014",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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