{
"Npi": {
"NPI": "1114189420",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JUST 4 KIDZ THERAPY, 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": "291 S PRESTON RD STE 830",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PROSPER",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75078-1907",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-347-9454",
"MailingAddressFaxNumber": "972-499-2527",
"FirstLinePracticeLocationAddress": "291 S PRESTON RD STE 830",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PROSPER",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75078-1907",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-347-9454",
"PracticeLocationAddressFaxNumber": "972-499-2527",
"EnumerationDate": "06/27/2008",
"LastUpdateDate": "01/27/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "POLK",
"AuthorizedOfficialFirstName": "CHADDRICK",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "C.F.O",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "972-283-3100",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "110553",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}