NPI Code Detail JSON Logo

1669008934 NPI number — ANGENIDA HOSPICE LLC

NPI Number: 1669008934
Health Care Provider/Practitioner: ANGENIDA HOSPICE LLC

Information about “1669008934” NPI (ANGENIDA HOSPICE LLC) exists in 1669008934 in HTML format HTML  |  1669008934 in plain Text format TXT  |  1669008934 in PDF (Portable Document Format) PDF  |  1669008934 in an XML format XML  formats.

NPI Number : 1669008934 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1669008934",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ANGENIDA HOSPICE LLC",
    "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": "14081 YORBA ST STE 201",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TUSTIN",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "92780-2011",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "714-442-3853",
    "MailingAddressFaxNumber": "714-442-4853",
    "FirstLinePracticeLocationAddress": "14081 YORBA ST STE 201",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TUSTIN",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92780-2011",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "714-442-3853",
    "PracticeLocationAddressFaxNumber": "714-442-4853",
    "EnumerationDate": "03/19/2020",
    "LastUpdateDate": "03/19/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "DAVID",
    "AuthorizedOfficialFirstName": "FERNAN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "714-442-3853",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251G00000X",
          "TaxonomyName": "Community Based Hospice Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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