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1861850653 NPI number — BEHAVIOR MANAGEMENT FOUNDATION

NPI Number: 1861850653
Health Care Provider/Practitioner: BEHAVIOR MANAGEMENT FOUNDATION

Information about “1861850653” NPI (BEHAVIOR MANAGEMENT FOUNDATION) exists in 1861850653 in HTML format HTML  |  1861850653 in plain Text format TXT  |  1861850653 in PDF (Portable Document Format) PDF  |  1861850653 in an XML format XML  formats.

NPI Number : 1861850653 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1861850653",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "BEHAVIOR MANAGEMENT FOUNDATION",
    "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": "584 E BELLEVUE RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ATWATER",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95301-2300",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "559-747-2177",
    "MailingAddressFaxNumber": "559-751-2295",
    "FirstLinePracticeLocationAddress": "584 E BELLEVUE RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ATWATER",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95301-2300",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "559-747-2177",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/08/2016",
    "LastUpdateDate": "02/09/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "NOWICKI",
    "AuthorizedOfficialFirstName": "JONATHAN",
    "AuthorizedOfficialMiddleName": "PAUL",
    "AuthorizedOfficialTitle": "CEO/CLINICAL DIRECTOR",
    "AuthorizedOfficialNamePrefix": "MR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "BCBA",
    "AuthorizedOfficialTelephoneNumber": "559-647-0004",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103K00000X",
          "TaxonomyName": "Behavior Analyst",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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