1699136317 NPI number — HOPE BEHAVIORAL HEALTH & ADDICTIVE DISEASE WELLNESS CENTER

NPI Number: 1699136317
Health Care Provider/Practitioner: HOPE BEHAVIORAL HEALTH & ADDICTIVE DISEASE WELLNESS CENTER

NPI Number : 1699136317 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1699136317",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "HOPE BEHAVIORAL HEALTH & ADDICTIVE DISEASE WELLNESS CENTER",
    "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": "218 S MACARTHUR DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CAMILLA",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "31730-7410",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "229-336-1702",
    "MailingAddressFaxNumber": "229-336-1701",
    "FirstLinePracticeLocationAddress": "218 S MACARTHUR DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CAMILLA",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "31730-7410",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "229-336-1702",
    "PracticeLocationAddressFaxNumber": "229-336-1701",
    "EnumerationDate": "03/08/2016",
    "LastUpdateDate": "03/08/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HARRIS",
    "AuthorizedOfficialFirstName": "SHUNTOL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OFFICE MANAGER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "229-798-3929",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QR0405X",
          "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}