NPI Code Detail JSON Logo

1588968937 NPI number — ANDREA MARTIN HOME, INC

NPI Number: 1588968937
Health Care Provider/Practitioner: ANDREA MARTIN HOME, INC

Information about “1588968937” NPI (ANDREA MARTIN HOME, INC) exists in 1588968937 in HTML format HTML  |  1588968937 in plain Text format TXT  |  1588968937 in PDF (Portable Document Format) PDF  |  1588968937 in an XML format XML  formats.

NPI Number : 1588968937 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1588968937",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ANDREA MARTIN HOME, 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": "17851 SW 11TH CT",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PEMBROKE PINES",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33029-4412",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "786-718-4560",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "17851 SW 11TH CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PEMBROKE PINES",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33029-4412",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "786-718-4560",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "12/28/2010",
    "LastUpdateDate": "12/28/2010",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FARJE",
    "AuthorizedOfficialFirstName": "RUBY",
    "AuthorizedOfficialMiddleName": "EDITH",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "786-718-4560",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "3104A0625X",
          "TaxonomyName": "Assisted Living Facility (Mental Illness)",
          "LicenseNumber": "AL11900",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3104A0630X",
          "TaxonomyName": "Assisted Living Facility (Behavioral Disturbances)",
          "LicenseNumber": "AL11900",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "310400000X",
          "TaxonomyName": "Assisted Living Facility",
          "LicenseNumber": "AL11900",
          "LicenseNumberStateCode": "FL",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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