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1740835834 NPI number — CRT CHILDREN SERVICES LLC

NPI Number: 1740835834
Health Care Provider/Practitioner: CRT CHILDREN SERVICES LLC

Information about “1740835834” NPI (CRT CHILDREN SERVICES LLC) exists in 1740835834 in HTML format HTML  |  1740835834 in plain Text format TXT  |  1740835834 in PDF (Portable Document Format) PDF  |  1740835834 in an XML format XML  formats.

NPI Number : 1740835834 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740835834",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "CRT CHILDREN SERVICES 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 3491",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MOSCOW",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83843-1912",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-340-2370",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "212 RODEO DR STE 510",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MOSCOW",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83843-9795",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-874-8002",
    "PracticeLocationAddressFaxNumber": "208-596-4010",
    "EnumerationDate": "08/06/2019",
    "LastUpdateDate": "09/15/2021",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "STOWE",
    "AuthorizedOfficialFirstName": "CALVIN",
    "AuthorizedOfficialMiddleName": "ROGER",
    "AuthorizedOfficialTitle": "ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "208-340-2370",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "106E00000X",
          "TaxonomyName": "Assistant Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "106S00000X",
          "TaxonomyName": "Behavior Technician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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