{
"Npi": {
"NPI": "1144460577",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "REHABNET OUTPATIENT CENTER",
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"OrgName": "REHABNET OUTPATIENT CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5966 JAMIESON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ENCINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91316-1018",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-344-6433",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1260 15TH ST",
"SecondLinePracticeLocationAddress": "SUITE 900",
"PracticeLocationAddressCityName": "SANTA MONICA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90404-1135",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-651-2292",
"PracticeLocationAddressFaxNumber": "310-451-2554",
"EnumerationDate": "02/25/2009",
"LastUpdateDate": "02/25/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NORRIS",
"AuthorizedOfficialFirstName": "WENDY",
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"AuthorizedOfficialTitle": "DIRECTOR",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-451-2292",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": "OT 6103",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}