NPI Code Detail JSON Logo

1407201924 NPI number — BREATH OF LIFE

NPI Number: 1407201924
Health Care Provider/Practitioner: BREATH OF LIFE

Information about “1407201924” NPI (BREATH OF LIFE) exists in 1407201924 in HTML format HTML  |  1407201924 in plain Text format TXT  |  1407201924 in PDF (Portable Document Format) PDF  |  1407201924 in an XML format XML  formats.

NPI Number : 1407201924 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407201924",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BREATH OF LIFE",
    "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": "1542 IRATCABAL DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "SPARKS",
    "MailingAddressStateName": "NV",
    "MailingAddressPostalCode": "89436-8637",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "775-354-0707",
    "MailingAddressFaxNumber": "775-626-5880",
    "FirstLinePracticeLocationAddress": "4944 DIANA CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SPARKS",
    "PracticeLocationAddressStateName": "NV",
    "PracticeLocationAddressPostalCode": "89436-8634",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "775-354-0707",
    "PracticeLocationAddressFaxNumber": "775-626-5880",
    "EnumerationDate": "05/03/2016",
    "LastUpdateDate": "10/17/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "COOPER",
    "AuthorizedOfficialFirstName": "BERNADETTE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "SUPPORTED LIVING ARRANGEMENT PROV.",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "775-626-5880",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "320900000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
          "LicenseNumber": "NV20111404144",
          "LicenseNumberStateCode": "NV",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385H00000X",
          "TaxonomyName": "Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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