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1740535962 NPI number — SOCIAL SERVICES INSTITUTE, LLC

NPI Number: 1740535962
Health Care Provider/Practitioner: SOCIAL SERVICES INSTITUTE, LLC

Information about “1740535962” NPI (SOCIAL SERVICES INSTITUTE, LLC) exists in 1740535962 in HTML format HTML  |  1740535962 in plain Text format TXT  |  1740535962 in PDF (Portable Document Format) PDF  |  1740535962 in an XML format XML  formats.

NPI Number : 1740535962 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740535962",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SOCIAL SERVICES INSTITUTE, 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": "PO BOX 1821",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MABLETON",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30126-1013",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "770-944-7280",
    "MailingAddressFaxNumber": "770-944-7280",
    "FirstLinePracticeLocationAddress": "4581 DURON PL SW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MABLETON",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30126-1177",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "770-944-7280",
    "PracticeLocationAddressFaxNumber": "770-944-7280",
    "EnumerationDate": "07/14/2012",
    "LastUpdateDate": "07/14/2012",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ROBERSON",
    "AuthorizedOfficialFirstName": "HENRY",
    "AuthorizedOfficialMiddleName": "EARL",
    "AuthorizedOfficialTitle": "CLINICAL DIRECTOR/OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "LCSW",
    "AuthorizedOfficialTelephoneNumber": "770-944-7280",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251300000X",
          "TaxonomyName": "Local Education Agency (LEA)",
          "LicenseNumber": "CSW001776",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": "CSW001776",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": "CSW001776",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": "CSW001776",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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