1508722117 NPI number — PINK ELEPHANT COMMUNITY & FAMILY SERVICES LLC

NPI Number: 1508722117
Health Care Provider/Practitioner: PINK ELEPHANT COMMUNITY & FAMILY SERVICES LLC

NPI Number : 1508722117 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508722117",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PINK ELEPHANT COMMUNITY & FAMILY SERVICES LLC",
    "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": "7531 REPUBLIC CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ALEXANDRIA",
    "MailingAddressStateName": "VA",
    "MailingAddressPostalCode": "22306-7531",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "571-637-4227",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7531 REPUBLIC CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ALEXANDRIA",
    "PracticeLocationAddressStateName": "VA",
    "PracticeLocationAddressPostalCode": "22306-7531",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "571-637-4227",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/27/2025",
    "LastUpdateDate": "12/27/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HORSEY",
    "AuthorizedOfficialFirstName": "LEON",
    "AuthorizedOfficialMiddleName": "CHARLES",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": "III",
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "571-637-4227",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251C00000X",
          "TaxonomyName": "Developmentally Disabled Services Day Training Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253J00000X",
          "TaxonomyName": "Foster Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251E00000X",
          "TaxonomyName": "Home Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0400X",
          "TaxonomyName": "Rehabilitation Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": null,
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          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "343900000X",
          "TaxonomyName": "Non-emergency Medical Transport (VAN)",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "347E00000X",
          "TaxonomyName": "Transportation Broker",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "174200000X",
          "TaxonomyName": "Meals Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}