{
"Npi": {
"NPI": "1053918698",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "DISCOVERY PRACTICE MANAGEMENT, INC.",
"ParentOrgTIN": null,
"OrgName": "DISCOVERY PRACTICE MANAGEMENT, 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": "4281 KATELLA AVE STE 111",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ALAMITOS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90720-3588",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-588-4722",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "40903 236TH AVE SE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ENUMCLAW",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98022-8606",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-218-2832",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/06/2020",
"LastUpdateDate": "10/06/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRYANT",
"AuthorizedOfficialFirstName": "NATALIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "DIRECTOR OF BUSINESS DEVELOPMENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "562-588-4722",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "323P00000X",
"TaxonomyName": "Psychiatric Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}