{
"Npi": {
"NPI": "1164821419",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CREATIVE CARE SOLUTIONS, 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": "455 E WYLIE FARM RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BLOOMINGTON",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47401-4591",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "812-219-8341",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "455 E WYLIE FARM RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BLOOMINGTON",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "47401-4591",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "812-219-8341",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/21/2014",
"LastUpdateDate": "08/21/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILKIN",
"AuthorizedOfficialFirstName": "DEBORAH",
"AuthorizedOfficialMiddleName": "CHERRY",
"AuthorizedOfficialTitle": "SECRETARY",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "812-219-8341",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": "34004227A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "34004227A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "34004227A",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}