NPI Code Detail JSON Logo

1891573424 NPI number — REHOBOTH SUPPORT SERVICES LLC

NPI Number: 1891573424
Health Care Provider/Practitioner: REHOBOTH SUPPORT SERVICES LLC

Information about “1891573424” NPI (REHOBOTH SUPPORT SERVICES LLC) exists in 1891573424 in HTML format HTML  |  1891573424 in plain Text format TXT  |  1891573424 in PDF (Portable Document Format) PDF  |  1891573424 in an XML format XML  formats.

NPI Number : 1891573424 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1891573424",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "REHOBOTH SUPPORT SERVICES 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": "7007 SEQUOIA PL",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BELTSVILLE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "20705-1463",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "202-740-9056",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "7007 SEQUOIA PL",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BELTSVILLE",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "20705-1463",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "202-740-9056",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/15/2023",
    "LastUpdateDate": "09/15/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "FADIPE",
    "AuthorizedOfficialFirstName": "ATINUKE",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "RN",
    "AuthorizedOfficialTelephoneNumber": "240-278-1871",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QD1600X",
        "TaxonomyName": "Developmental Disabilities Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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