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1851793970 NPI number — ANGEL WINGS ACTIVITY CENTER, CORP

NPI Number: 1851793970
Health Care Provider/Practitioner: ANGEL WINGS ACTIVITY CENTER, CORP

Information about “1851793970” NPI (ANGEL WINGS ACTIVITY CENTER, CORP) exists in 1851793970 in HTML format HTML  |  1851793970 in plain Text format TXT  |  1851793970 in PDF (Portable Document Format) PDF  |  1851793970 in an XML format XML  formats.

NPI Number : 1851793970 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851793970",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ANGEL WINGS ACTIVITY CENTER, CORP",
    "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": "3427 W WOOLBRIGHT RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOYNTON BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33436-7246",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "561-737-0405",
    "MailingAddressFaxNumber": "561-737-0409",
    "FirstLinePracticeLocationAddress": "3427 W. WOOLBRIGHT RD.",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOYNTON BEACH",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "33436",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "561-737-0405",
    "PracticeLocationAddressFaxNumber": "561-737-0409",
    "EnumerationDate": "09/19/2014",
    "LastUpdateDate": "09/19/2014",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GARCIA",
    "AuthorizedOfficialFirstName": "EVELYN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER/ ADMINISTRATOR",
    "AuthorizedOfficialNamePrefix": "MS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "561-737-0405",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "385H00000X",
        "TaxonomyName": "Respite Care",
        "LicenseNumber": "9287",
        "LicenseNumberStateCode": "FL",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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