{
"Npi": {
"NPI": "1174736342",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "GENE CARE, INC",
"ParentOrgTIN": null,
"OrgName": "GENE CARE INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4657 ELLENITA AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TARZANA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91356-4931",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-618-6167",
"MailingAddressFaxNumber": "818-881-4983",
"FirstLinePracticeLocationAddress": "324 PALOMA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "POMONA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91767-5620",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-623-7000",
"PracticeLocationAddressFaxNumber": "909-623-7041",
"EnumerationDate": "05/07/2007",
"LastUpdateDate": "08/30/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GODLEWSKA",
"AuthorizedOfficialFirstName": "ELIZABETH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.S.",
"AuthorizedOfficialTelephoneNumber": "909-623-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}