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1992647804 NPI number — FROM ASHES WE RISE LLC

NPI Number: 1992647804
Health Care Provider/Practitioner: FROM ASHES WE RISE LLC

Information about “1992647804” NPI (FROM ASHES WE RISE LLC) exists in 1992647804 in HTML format HTML  |  1992647804 in plain Text format TXT  |  1992647804 in PDF (Portable Document Format) PDF  |  1992647804 in an XML format XML  formats.

NPI Number : 1992647804 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1992647804",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FROM ASHES WE RISE 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": "12124 ROESTA LN NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BALTIMORE",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "43105-9200",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "614-582-2977",
    "MailingAddressFaxNumber": "614-591-3744",
    "FirstLinePracticeLocationAddress": "12124 ROESTA LN NW",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "BALTIMORE",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "43105-9200",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "614-582-2977",
    "PracticeLocationAddressFaxNumber": "614-591-3744",
    "EnumerationDate": "04/08/2026",
    "LastUpdateDate": "04/08/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "LEACH",
    "AuthorizedOfficialFirstName": "LETISHA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "APRN, FNP, PMHNP",
    "AuthorizedOfficialTelephoneNumber": "614-300-7977",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251S00000X",
        "TaxonomyName": "Community/Behavioral Health Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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