NPI Code Detail JSON Logo

1609236041 NPI number — CREATING CHANGE

NPI Number: 1609236041
Health Care Provider/Practitioner: CREATING CHANGE

Information about “1609236041” NPI (CREATING CHANGE) exists in 1609236041 in HTML format HTML  |  1609236041 in plain Text format TXT  |  1609236041 in PDF (Portable Document Format) PDF  |  1609236041 in an XML format XML  formats.

NPI Number : 1609236041 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609236041",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CREATING CHANGE",
    "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": "373 S YUKON PKWY",
    "SecondLineMailingAddress": "SUITE B",
    "MailingAddressCityName": "YUKON",
    "MailingAddressStateName": "OK",
    "MailingAddressPostalCode": "73099-4596",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "405-265-0986",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "373 S YUKON PKWY",
    "SecondLinePracticeLocationAddress": "SUITE B",
    "PracticeLocationAddressCityName": "YUKON",
    "PracticeLocationAddressStateName": "OK",
    "PracticeLocationAddressPostalCode": "73099-4596",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "405-265-0986",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/27/2016",
    "LastUpdateDate": "03/05/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "NGUYEN",
    "AuthorizedOfficialFirstName": "VINH",
    "AuthorizedOfficialMiddleName": "THE",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "405-474-6741",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QM0801X",
        "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.