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1629307822 NPI number — INTERFACE CONSULTATION SERVICES

NPI Number: 1629307822
Health Care Provider/Practitioner: INTERFACE CONSULTATION SERVICES

Information about “1629307822” NPI (INTERFACE CONSULTATION SERVICES) exists in 1629307822 in HTML format HTML  |  1629307822 in plain Text format TXT  |  1629307822 in PDF (Portable Document Format) PDF  |  1629307822 in an XML format XML  formats.

NPI Number : 1629307822 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1629307822",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "Y",
    "ParentOrgLBN": "INTERFACE CONSULTATION SERVICES",
    "ParentOrgTIN": null,
    "OrgName": "INTERFACE CONSULTATION SERVICES",
    "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": "151 EMMETT ST E",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BATTLE CREEK",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "49017-3319",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "269-929-1292",
    "MailingAddressFaxNumber": "269-965-5267",
    "FirstLinePracticeLocationAddress": "151 EMMETT ST E",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BATTLE CREEK",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "49017-3319",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "269-929-1292",
    "PracticeLocationAddressFaxNumber": "269-965-5267",
    "EnumerationDate": "12/17/2009",
    "LastUpdateDate": "12/17/2009",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JUDD",
    "AuthorizedOfficialFirstName": "CRAIG",
    "AuthorizedOfficialMiddleName": "STUART",
    "AuthorizedOfficialTitle": "PROGRAM ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MA, LLP",
    "AuthorizedOfficialTelephoneNumber": "269-929-1292",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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