NPI Code Detail JSON Logo

1952080954 NPI number — SERENITY PLACE THERAPY LLC

NPI Number: 1952080954
Health Care Provider/Practitioner: SERENITY PLACE THERAPY LLC

Information about “1952080954” NPI (SERENITY PLACE THERAPY LLC) exists in 1952080954 in HTML format HTML  |  1952080954 in plain Text format TXT  |  1952080954 in PDF (Portable Document Format) PDF  |  1952080954 in an XML format XML  formats.

NPI Number : 1952080954 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1952080954",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "SERENITY PLACE THERAPY 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": "265 S FEDERAL HWY # 285",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DEERFIELD BEACH",
    "MailingAddressStateName": "FL",
    "MailingAddressPostalCode": "33441-4161",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "276-224-2043",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "3445 WINTON PLACE",
    "SecondLinePracticeLocationAddress": "STE. 114",
    "PracticeLocationAddressCityName": "ROCHESTER",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "14623",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "276-224-2043",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "07/17/2023",
    "LastUpdateDate": "07/17/2023",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HOUCHIN",
    "AuthorizedOfficialFirstName": "PATRICIA",
    "AuthorizedOfficialMiddleName": "A",
    "AuthorizedOfficialTitle": "MANAGER/MEMBER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MA, LMHC",
    "AuthorizedOfficialTelephoneNumber": "276-224-2043",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "261QM0801X",
          "TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        },
        {
          "TaxonomyCode": "261QM0850X",
          "TaxonomyName": "Adult Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QM0855X",
          "TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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