{
"Npi": {
"NPI": "1043698400",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "DESTINY HEALTH MANAGEMENT SERVICES CORPORATION",
"ParentOrgTIN": null,
"OrgName": "NEW DESTINY CARE OF DFW-LEWISVILLE",
"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": "2810 E TRINITY MILLS RD",
"SecondLineMailingAddress": "SUITE 209-168",
"MailingAddressCityName": "CARROLLTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75006-2545",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "500 W MAIN ST",
"SecondLinePracticeLocationAddress": "SUITE 210",
"PracticeLocationAddressCityName": "LEWISVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75057-3641",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-634-0386",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/18/2015",
"LastUpdateDate": "05/18/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARKS",
"AuthorizedOfficialFirstName": "CLARENCE",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D",
"AuthorizedOfficialTelephoneNumber": "815-275-1540",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "011002",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}