NPI Code Detail JSON Logo

1831060821 NPI number — HOME AWAY FROM HOME OF PUTNAM CO., INC.

NPI Number: 1831060821
Health Care Provider/Practitioner: HOME AWAY FROM HOME OF PUTNAM CO., INC.

Information about “1831060821” NPI (HOME AWAY FROM HOME OF PUTNAM CO., INC.) exists in 1831060821 in HTML format HTML  |  1831060821 in plain Text format TXT  |  1831060821 in PDF (Portable Document Format) PDF  |  1831060821 in an XML format XML  formats.

NPI Number : 1831060821 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831060821",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "HOME AWAY FROM HOME OF PUTNAM CO., 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": "3108 SAINT JOHNS AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PALATKA",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32177-4132",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "386-385-3166",
    "MailingAddressFaxNumber": "386-385-3248",
    "FirstLinePracticeLocationAddress": "680 OLD SAN MATEO RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "SAN MATEO",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32187-2220",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "386-329-3208",
    "PracticeLocationAddressFaxNumber": "386-385-3248",
    "EnumerationDate": "09/15/2025",
    "LastUpdateDate": "09/15/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JACKSON",
    "AuthorizedOfficialFirstName": "TERESA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "386-329-3208",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "373H00000X",
        "TaxonomyName": "Day Training/Habilitation Specialist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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