{
"Npi": {
"NPI": "1164592309",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MEAPRIS COMMUNITY MENTAL HEALTH CORP.",
"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": "2475 NW 95TH AVE",
"SecondLineMailingAddress": "SUITE 1",
"MailingAddressCityName": "DORAL",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33172-2328",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "305-513-8565",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2475 NW 95TH AVE",
"SecondLinePracticeLocationAddress": "SUITE 1",
"PracticeLocationAddressCityName": "DORAL",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33172-2328",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "305-513-8565",
"PracticeLocationAddressFaxNumber": "305-513-9505",
"EnumerationDate": "11/08/2006",
"LastUpdateDate": "10/04/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GUNTIN",
"AuthorizedOfficialFirstName": "JOSE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "305-513-8565",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "HCC5711",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}