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1982045464 NPI number — AGENCY FOR CULTURAL ALLIANCE, LLC

NPI Number: 1982045464
Health Care Provider/Practitioner: AGENCY FOR CULTURAL ALLIANCE, LLC

Information about “1982045464” NPI (AGENCY FOR CULTURAL ALLIANCE, LLC) exists in 1982045464 in HTML format HTML  |  1982045464 in plain Text format TXT  |  1982045464 in PDF (Portable Document Format) PDF  |  1982045464 in an XML format XML  formats.

NPI Number : 1982045464 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1982045464",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "AGENCY FOR CULTURAL ALLIANCE, 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": "1655 W FAIRVIEW AVE STE 103",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BOISE",
    "MailingAddressStateName": "ID",
    "MailingAddressPostalCode": "83702-5173",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "208-407-1857",
    "MailingAddressFaxNumber": "208-906-8637",
    "FirstLinePracticeLocationAddress": "1655 W FAIRVIEW AVE STE 103",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BOISE",
    "PracticeLocationAddressStateName": "ID",
    "PracticeLocationAddressPostalCode": "83702-5173",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "208-407-1857",
    "PracticeLocationAddressFaxNumber": "208-906-8637",
    "EnumerationDate": "07/11/2013",
    "LastUpdateDate": "08/19/2013",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MARTINEZ",
    "AuthorizedOfficialFirstName": "STACEY",
    "AuthorizedOfficialMiddleName": "ANN",
    "AuthorizedOfficialTitle": "LLC MEMBER/MANAGER",
    "AuthorizedOfficialNamePrefix": "MRS.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "BS,CPRP",
    "AuthorizedOfficialTelephoneNumber": "208-407-1857",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "251S00000X",
          "TaxonomyName": "Community/Behavioral Health Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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