NPI Code Detail JSON Logo

1841157245 NPI number — LEGACY BRIDGE SUPPORT SERVICES LLC

NPI Number: 1841157245
Health Care Provider/Practitioner: LEGACY BRIDGE SUPPORT SERVICES LLC

Information about “1841157245” NPI (LEGACY BRIDGE SUPPORT SERVICES LLC) exists in 1841157245 in HTML format HTML  |  1841157245 in plain Text format TXT  |  1841157245 in PDF (Portable Document Format) PDF  |  1841157245 in an XML format XML  formats.

NPI Number : 1841157245 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1841157245",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LEGACY BRIDGE SUPPORT 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": "311 S BILBRO AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MURFREESBORO",
    "MailingAddressStateName": "TN",
    "MailingAddressPostalCode": "37130-4417",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "615-987-2523",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2615 MEDICAL CENTER PKWY",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MURFREESBORO",
    "PracticeLocationAddressStateName": "TN",
    "PracticeLocationAddressPostalCode": "37129-2261",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "615-318-0822",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "01/07/2026",
    "LastUpdateDate": "01/07/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FRAZIER",
    "AuthorizedOfficialFirstName": "KANESHA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/CEO/EXECUTIVE DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "615-987-2523",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320600000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253J00000X",
          "TaxonomyName": "Foster Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "320900000X",
          "TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261Q00000X",
          "TaxonomyName": "Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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