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1720470057 NPI number — METROPOLITAN DEVELOPMENT COUNCIL

NPI Number: 1720470057
Health Care Provider/Practitioner: METROPOLITAN DEVELOPMENT COUNCIL

Information about “1720470057” NPI (METROPOLITAN DEVELOPMENT COUNCIL) exists in 1720470057 in HTML format HTML  |  1720470057 in plain Text format TXT  |  1720470057 in PDF (Portable Document Format) PDF  |  1720470057 in an XML format XML  formats.

NPI Number : 1720470057 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1720470057",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "METROPOLITAN DEVELOPMENT COUNCIL",
    "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": "945 FAWCETT AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "TACOMA",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98402-5612",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "253-284-9049",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "721 FAWCETT AVE STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TACOMA",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98402-5502",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "253-207-4302",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/24/2015",
    "LastUpdateDate": "02/24/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "PEREBOOM",
    "AuthorizedOfficialFirstName": "MARK",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PERSIDENT AND CEO",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "253-591-0113",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "320800000X",
        "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
        "LicenseNumber": "RTF.FS.60503763",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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