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1831511393 NPI number — LIFESTYLES SUPPORTIVE LIVING SERVICES, LLC

NPI Number: 1831511393
Health Care Provider/Practitioner: LIFESTYLES SUPPORTIVE LIVING SERVICES, LLC

Information about “1831511393” NPI (LIFESTYLES SUPPORTIVE LIVING SERVICES, LLC) exists in 1831511393 in HTML format HTML  |  1831511393 in plain Text format TXT  |  1831511393 in PDF (Portable Document Format) PDF  |  1831511393 in an XML format XML  formats.

NPI Number : 1831511393 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1831511393",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LIFESTYLES SUPPORTIVE LIVING 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": "2370 E STADIUM BLVD # 640",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANN ARBOR",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48104-4811",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "734-726-4086",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2370 E STADIUM BLVD # 640",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANN ARBOR",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48104-4811",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-726-4086",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/16/2014",
    "LastUpdateDate": "04/19/2017",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THOMAS",
    "AuthorizedOfficialFirstName": "MANUEL",
    "AuthorizedOfficialMiddleName": "DEWITT",
    "AuthorizedOfficialTitle": "ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": "JR.",
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "734-726-4086",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "347C00000X",
          "TaxonomyName": "Private Vehicle",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "3747A0650X",
          "TaxonomyName": "Attendant Care Provider",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320800000X",
          "TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "MI",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "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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