NPI Code Detail JSON Logo

1821619438 NPI number — GROW WELL ABA, LLC

NPI Number: 1821619438
Health Care Provider/Practitioner: GROW WELL ABA, LLC

Information about “1821619438” NPI (GROW WELL ABA, LLC) exists in 1821619438 in HTML format HTML  |  1821619438 in plain Text format TXT  |  1821619438 in PDF (Portable Document Format) PDF  |  1821619438 in an XML format XML  formats.

NPI Number : 1821619438 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821619438",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "GROW WELL ABA, LLC",
    "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": "3402 PARSON CT FL 32223",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32223-7337",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-323-1782",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3402 PARSON CT",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32223-7337",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-434-0785",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "05/05/2020",
    "LastUpdateDate": "06/21/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JENKINS",
    "AuthorizedOfficialFirstName": "HELENA",
    "AuthorizedOfficialMiddleName": "DANEA",
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MS, BCBA",
    "AuthorizedOfficialTelephoneNumber": "904-434-0785",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "103K00000X",
        "TaxonomyName": "Behavior Analyst",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X 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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