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1659839470 NPI number — CROSS RIVERS, LLC

NPI Number: 1659839470
Health Care Provider/Practitioner: CROSS RIVERS, LLC

Information about “1659839470” NPI (CROSS RIVERS, LLC) exists in 1659839470 in HTML format HTML  |  1659839470 in plain Text format TXT  |  1659839470 in PDF (Portable Document Format) PDF  |  1659839470 in an XML format XML  formats.

NPI Number : 1659839470 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1659839470",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CROSS RIVERS, LLC",
    "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": "1500 JFK BLVD STE 1900",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PHILADELPHIA",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19102-1714",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-398-5564",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1500 JFK BLVD STE 1900",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PHILADELPHIA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19102-1714",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-398-5564",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/11/2019",
    "LastUpdateDate": "04/09/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "IGWE",
    "AuthorizedOfficialFirstName": "CHUKWUEMEKA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LAWYER",
    "AuthorizedOfficialTelephoneNumber": "215-398-5564",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251G00000X",
          "TaxonomyName": "Community Based Hospice Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "374U00000X",
          "TaxonomyName": "Home Health Aide",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251E00000X",
          "TaxonomyName": "Home Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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