1689814774 NPI number — CHASCIONE MANAGEMENT LLC

Table of content: MRS. MARY KAY KATHRYN GRAVES MPT (NPI 1437335130)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689814774 NPI number — CHASCIONE MANAGEMENT LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CHASCIONE MANAGEMENT LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEALING ARTS CENTER OF THE VILLAGES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1689814774
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9069 SE 136TH LOOP
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUMMERFIELD
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
34491-7977
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
772-708-7621
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
13940 N US HIGHWAY 441
Provider Second Line Business Practice Location Address:
SUITE 906
Provider Business Practice Location Address City Name:
THE VILLAGES
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
32159-8908
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
352-205-8305
Provider Business Practice Location Address Fax Number:
352-750-1993
Provider Enumeration Date:
03/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
GEORGIADES
Authorized Official First Name:
BARBARA
Authorized Official Middle Name:
H
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
772-708-7621

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208D00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)





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