{
"Npi": {
"NPI": "1114097557",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COVIA COMMUNITIES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2185 N CALIFORNIA BLVD STE 215",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WALNUT CREEK",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94596-3566",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "925-956-7400",
"MailingAddressFaxNumber": "925-407-0060",
"FirstLinePracticeLocationAddress": "5555 MONTGOMERY DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SANTA ROSA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95409-8846",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "707-538-8400",
"PracticeLocationAddressFaxNumber": "707-579-6997",
"EnumerationDate": "11/09/2006",
"LastUpdateDate": "01/13/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAMISON",
"AuthorizedOfficialFirstName": "DIANA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CFO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "925-953-7446",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "490107656",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}