NPI Code Detail JSON Logo

1861349060 NPI number — LEGACY HEIRS CONSUMER SERVICES INC

NPI Number: 1861349060
Health Care Provider/Practitioner: LEGACY HEIRS CONSUMER SERVICES INC

Information about “1861349060” NPI (LEGACY HEIRS CONSUMER SERVICES INC) exists in 1861349060 in HTML format HTML  |  1861349060 in plain Text format TXT  |  1861349060 in PDF (Portable Document Format) PDF  |  1861349060 in an XML format XML  formats.

NPI Number : 1861349060 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861349060",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LEGACY HEIRS CONSUMER SERVICES 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": "1088 RHONDA RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "JACKSONVILLE",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "32254-2532",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "904-667-1692",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1839 LANE AVE S STE 202",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "JACKSONVILLE",
    "PracticeLocationAddressStateName": "FL",
    "PracticeLocationAddressPostalCode": "32210-1260",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "904-667-1692",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/16/2026",
    "LastUpdateDate": "03/16/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "REYNOLDS",
    "AuthorizedOfficialFirstName": "DESTINY",
    "AuthorizedOfficialMiddleName": "IMARI",
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": "MISS",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "904-667-1692",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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