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1790326320 NPI number — ACCESS: SUPPORTS FOR LIVING INC.

NPI Number: 1790326320
Health Care Provider/Practitioner: ACCESS: SUPPORTS FOR LIVING INC.

Information about “1790326320” NPI (ACCESS: SUPPORTS FOR LIVING INC.) exists in 1790326320 in HTML format HTML  |  1790326320 in plain Text format TXT  |  1790326320 in PDF (Portable Document Format) PDF  |  1790326320 in an XML format XML  formats.

NPI Number : 1790326320 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1790326320",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ACCESS: SUPPORTS FOR LIVING INC.",
    "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": "15 FORTUNE RD W",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIDDLETOWN",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10941-1625",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "845-692-4454",
    "MailingAddressFaxNumber": "845-692-8887",
    "FirstLinePracticeLocationAddress": "16 UNION ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIDDLETOWN",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10940-4906",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "845-692-4454",
    "PracticeLocationAddressFaxNumber": "845-692-8887",
    "EnumerationDate": "10/04/2019",
    "LastUpdateDate": "10/04/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "COLAVITO",
    "AuthorizedOfficialFirstName": "RONALD",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "845-692-4454",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QR0405X",
        "TaxonomyName": "Substance Use Disorder Rehabilitation Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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