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1780751966 NPI number — VALLEY VISTA CARE CORPORATION

NPI Number: 1780751966
Health Care Provider/Practitioner: VALLEY VISTA CARE CORPORATION

Information about “1780751966” NPI (VALLEY VISTA CARE CORPORATION) exists in 1780751966 in HTML format HTML  |  1780751966 in plain Text format TXT  |  1780751966 in PDF (Portable Document Format) PDF  |  1780751966 in an XML format XML  formats.

NPI Number : 1780751966 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1780751966",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "VALLEY VISTA CARE CORPORATION",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "820 ELM ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ST MARIES",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83861-2119",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-245-4576",
    "MailingAddressFaxNumber": "208-245-2138",
    "FirstLinePracticeLocationAddress": "4433 BEVERLAND ROAD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MACKAY",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83251-0239",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-588-2600",
    "PracticeLocationAddressFaxNumber": "208-588-3104",
    "EnumerationDate": "11/30/2006",
    "LastUpdateDate": "08/22/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MILLS",
    "AuthorizedOfficialFirstName": "GAIL",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CORPORATE COMPLIANCE MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "208-245-4576",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "3104A0630X",
        "TaxonomyName": "Assisted Living Facility (Behavioral Disturbances)",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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