{
"Npi": {
"NPI": "1053521740",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CAMP SUMMIT, INC.",
"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": "17210 CAMPBELL RD STE 180",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "DALLAS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75252-4203",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-484-8900",
"MailingAddressFaxNumber": "972-620-1945",
"FirstLinePracticeLocationAddress": "270 PRIVATE ROAD 3475",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PARADISE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76073-4008",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "940-433-3338",
"PracticeLocationAddressFaxNumber": "940-620-1945",
"EnumerationDate": "05/23/2007",
"LastUpdateDate": "06/11/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEILAND",
"AuthorizedOfficialFirstName": "CARLA",
"AuthorizedOfficialMiddleName": "R.",
"AuthorizedOfficialTitle": "CHEIF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "972-484-8900",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "385HR2050X",
"TaxonomyName": "Respite Care Camp",
"LicenseNumber": "061001",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}