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1558278085 NPI number — LA PERLE DIVINE CARE LIVING LLC

NPI Number: 1558278085
Health Care Provider/Practitioner: LA PERLE DIVINE CARE LIVING LLC

Information about “1558278085” NPI (LA PERLE DIVINE CARE LIVING LLC) exists in 1558278085 in HTML format HTML  |  1558278085 in plain Text format TXT  |  1558278085 in PDF (Portable Document Format) PDF  |  1558278085 in an XML format XML  formats.

NPI Number : 1558278085 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1558278085",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LA PERLE DIVINE CARE LIVING 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": "1541 ASHBORO CIR SE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALM BAY",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32909-6631",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "321-464-0391",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1541 ASHBORO CIR SE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PALM BAY",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32909-6631",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "321-464-0391",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/27/2026",
    "LastUpdateDate": "08/27/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "IMBERT",
    "AuthorizedOfficialFirstName": "SASKIA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/MANAGING MEMBER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "IMBERT",
    "AuthorizedOfficialTelephoneNumber": "954-440-8588",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "320900000X",
        "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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