NPI Code Detail JSON Logo

1356779409 NPI number — C4C COASTAL BEND INC,

NPI Number: 1356779409
Health Care Provider/Practitioner: C4C COASTAL BEND INC,

Information about “1356779409” NPI (C4C COASTAL BEND INC,) exists in 1356779409 in HTML format HTML  |  1356779409 in plain Text format TXT  |  1356779409 in PDF (Portable Document Format) PDF  |  1356779409 in an XML format XML  formats.

NPI Number : 1356779409 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1356779409",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "C4C COASTAL BEND INC,",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "7405 GREENBACK LN # 140",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CITRUS HEIGHTS",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95621",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "916-870-9590",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "302 AVENUE D",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "VICTORIA",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "77901-8529",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "361-649-1858",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/29/2013",
    "LastUpdateDate": "09/04/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "POWELL",
    "AuthorizedOfficialFirstName": "JILL",
    "AuthorizedOfficialMiddleName": "ANN",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "916-870-9590",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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