{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MEMCARE LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "187 OLD STAGE RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SANBORNVILLE",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03872-4627",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-522-9412",
"MailingAddressFaxNumber": "603-522-3234",
"FirstLinePracticeLocationAddress": "27 JUNE ST",
"SecondLinePracticeLocationAddress": "THIRD FLOOR",
"PracticeLocationAddressCityName": "SANFORD",
"PracticeLocationAddressStateName": "ME",
"PracticeLocationAddressPostalCode": "04073-2621",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "207-490-0900",
"PracticeLocationAddressFaxNumber": "207-490-0902",
"EnumerationDate": "08/19/2008",
"LastUpdateDate": "08/19/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOBTI",
"AuthorizedOfficialFirstName": "SANDEEP",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "603-522-9412",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "2084P0805X",
"TaxonomyName": "Geriatric Psychiatry Physician",
"LicenseNumber": "17566",
"LicenseNumberStateCode": "ME",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
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"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}