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1871441139 NPI number — ACCENT SENIOR CLUB #1, LLC

NPI Number: 1871441139
Health Care Provider/Practitioner: ACCENT SENIOR CLUB #1, LLC

Information about “1871441139” NPI (ACCENT SENIOR CLUB #1, LLC) exists in 1871441139 in HTML format HTML  |  1871441139 in plain Text format TXT  |  1871441139 in PDF (Portable Document Format) PDF  |  1871441139 in an XML format XML  formats.

NPI Number : 1871441139 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1871441139",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ACCENT SENIOR CLUB #1, 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": "6409 CITY WEST PKWY STE 100A",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EDEN PRAIRIE",
    "MailingAddressStateName": "MN",
    "MailingAddressPostalCode": "55344-7845",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "952-456-8630",
    "MailingAddressFaxNumber": "952-456-8485",
    "FirstLinePracticeLocationAddress": "6409 CITY WEST PKWY STE 100A",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EDEN PRAIRIE",
    "PracticeLocationAddressStateName": "MN",
    "PracticeLocationAddressPostalCode": "55344-7845",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "952-456-8630",
    "PracticeLocationAddressFaxNumber": "952-456-8485",
    "EnumerationDate": "03/20/2026",
    "LastUpdateDate": "03/20/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SHEVTSOV",
    "AuthorizedOfficialFirstName": "RADA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PRESIDENT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "612-247-1547",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "253Z00000X",
        "TaxonomyName": "In Home Supportive Care Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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