{
"Npi": {
"NPI": "1093860744",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMMUNITY SERVICE ASSOCIATES, LLC",
"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": "4008 LOUETTA RD.",
"SecondLineMailingAddress": "#179",
"MailingAddressCityName": "SPRING",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77388",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "281-355-8260",
"MailingAddressFaxNumber": "281-355-0567",
"FirstLinePracticeLocationAddress": "3502 BLUE LAKE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPRING",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77388-5103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "281-355-8260",
"PracticeLocationAddressFaxNumber": "281-355-0567",
"EnumerationDate": "01/24/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CUNDIFF",
"AuthorizedOfficialFirstName": "CHRISTINE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "281-355-8260",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251C00000X",
"TaxonomyName": "Developmentally Disabled Services Day Training Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251C00000X",
"TaxonomyName": "Developmentally Disabled Services Day Training Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251C00000X",
"TaxonomyName": "Developmentally Disabled Services Day Training Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}