NPI Code Detail JSON Logo

1609271394 NPI number — RANCH MALIBU VENTURE 1

NPI Number: 1609271394
Health Care Provider/Practitioner: RANCH MALIBU VENTURE 1

Information about “1609271394” NPI (RANCH MALIBU VENTURE 1) exists in 1609271394 in HTML format HTML  |  1609271394 in plain Text format TXT  |  1609271394 in PDF (Portable Document Format) PDF  |  1609271394 in an XML format XML  formats.

NPI Number : 1609271394 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1609271394",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RANCH MALIBU VENTURE 1",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "327 S. LATIGO CYN ROAD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MALIBU",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90265",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "818-879-9110",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "327 LATIGO CANYON RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MALIBU",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90265-2708",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "818-879-9110",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/24/2014",
    "LastUpdateDate": "10/24/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HAMILTON",
    "AuthorizedOfficialFirstName": "CAROLYN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "BILLING MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "818-667-6550",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "324500000X",
        "TaxonomyName": "Substance Abuse Rehabilitation Facility",
        "LicenseNumber": "190649AP",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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