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1871384180 NPI number — ANGEL COMMUNITY ALLIANCE, INC

NPI Number: 1871384180
Health Care Provider/Practitioner: ANGEL COMMUNITY ALLIANCE, INC

Information about “1871384180” NPI (ANGEL COMMUNITY ALLIANCE, INC) exists in 1871384180 in HTML format HTML  |  1871384180 in plain Text format TXT  |  1871384180 in PDF (Portable Document Format) PDF  |  1871384180 in an XML format XML  formats.

NPI Number : 1871384180 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871384180",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ANGEL COMMUNITY ALLIANCE, INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "508 BEACH 22ND ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FAR ROCKAWAY",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11691-2678",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "929-427-9677",
    "MailingAddressFaxNumber": "516-268-9322",
    "FirstLinePracticeLocationAddress": "508 BEACH 22ND ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FAR ROCKAWAY",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11691-2678",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "929-427-9677",
    "PracticeLocationAddressFaxNumber": "516-268-9322",
    "EnumerationDate": "05/15/2025",
    "LastUpdateDate": "05/30/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "JAMES",
    "AuthorizedOfficialFirstName": "ANGELICKA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "929-426-9677",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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