1679346480 NPI number — TESTAS HEALTHCARE SERVICES INC

NPI Number: 1679346480
Health Care Provider/Practitioner: TESTAS HEALTHCARE SERVICES INC

NPI Number : 1679346480 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1679346480",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "TESTAS HEALTHCARE SERVICES INC",
    "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": "607 E ABRAM ST STE 14",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ARLINGTON",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "76010-1206",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "817-883-4452",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "607 E ABRAM ST STE 14",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ARLINGTON",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "76010-1206",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "817-883-4452",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "11/02/2023",
    "LastUpdateDate": "11/02/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ASEKUN",
    "AuthorizedOfficialFirstName": "SIMISOLA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "817-883-4452",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251J00000X",
          "TaxonomyName": "Nursing Care Agency",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QA0600X",
          "TaxonomyName": "Adult Day Care Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QI0500X",
          "TaxonomyName": "Infusion Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "347E00000X",
          "TaxonomyName": "Transportation Broker",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363LP0808X",
          "TaxonomyName": "Psychiatric/Mental Health Nurse Practitioner",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
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          "TaxonomyName": "Methadone Clinic",
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          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2055X",
          "TaxonomyName": "Child Mental Illness Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "385HR2060X",
          "TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "343800000X",
          "TaxonomyName": "Secured Medical Transport (VAN)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}