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1962205658 NPI number — LEAD BY EXAMPLE, REVERSE THE TREND

NPI Number: 1962205658
Health Care Provider/Practitioner: LEAD BY EXAMPLE, REVERSE THE TREND

Information about “1962205658” NPI (LEAD BY EXAMPLE, REVERSE THE TREND) exists in 1962205658 in HTML format HTML  |  1962205658 in plain Text format TXT  |  1962205658 in PDF (Portable Document Format) PDF  |  1962205658 in an XML format XML  formats.

NPI Number : 1962205658 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1962205658",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "LEAD BY EXAMPLE, REVERSE THE TREND",
    "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": "8 W 126TH ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NEW YORK",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "10027-3811",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "732-430-9020",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2916 8TH AVE STE 2",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NEW YORK",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "10039-1619",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "732-430-9020",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/29/2025",
    "LastUpdateDate": "03/29/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "HENDRICKSON",
    "AuthorizedOfficialFirstName": "ANTHONY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CEO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "732-430-9020",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "324500000X",
        "TaxonomyName": "Substance Abuse Rehabilitation Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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