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1578413134 NPI number — GREAT EXPECTATIONS OF LAKE COUNTY CORPORATION

NPI Number: 1578413134
Health Care Provider/Practitioner: GREAT EXPECTATIONS OF LAKE COUNTY CORPORATION

Information about “1578413134” NPI (GREAT EXPECTATIONS OF LAKE COUNTY CORPORATION) exists in 1578413134 in HTML format HTML  |  1578413134 in plain Text format TXT  |  1578413134 in PDF (Portable Document Format) PDF  |  1578413134 in an XML format XML  formats.

NPI Number : 1578413134 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1578413134",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GREAT EXPECTATIONS OF LAKE COUNTY CORPORATION",
    "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": "1310 W NORTH BLVD STE 2",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LEESBURG",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "34748-3922",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "352-314-0202",
    "MailingAddressFaxNumber": "352-504-0233",
    "FirstLinePracticeLocationAddress": "5345 TWIN PALMS RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FRUITLAND PARK",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "34731-6050",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "352-314-0202",
    "PracticeLocationAddressFaxNumber": "352-504-0233",
    "EnumerationDate": "02/02/2026",
    "LastUpdateDate": "02/02/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FLANNERY",
    "AuthorizedOfficialFirstName": "TINA",
    "AuthorizedOfficialMiddleName": "MARIE",
    "AuthorizedOfficialTitle": "OWNER/DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "352-460-7009",
    "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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