{
"Npi": {
"NPI": "1174877757",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "S.O.B HEALTH SYSTEM LLC",
"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": "335 E JIMMIE LEEDS RD",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "GALLOWAY",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08205-4127",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "609-573-5310",
"MailingAddressFaxNumber": "609-241-1922",
"FirstLinePracticeLocationAddress": "335 E JIMMIE LEEDS RD",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "GALLOWAY",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "08205-4127",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "609-573-5310",
"PracticeLocationAddressFaxNumber": "609-241-1922",
"EnumerationDate": "11/02/2012",
"LastUpdateDate": "03/22/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BILEWU",
"AuthorizedOfficialFirstName": "EBENEZER",
"AuthorizedOfficialMiddleName": "O-A",
"AuthorizedOfficialTitle": "CHIROPRACTIC PHYSICIAN",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C",
"AuthorizedOfficialTelephoneNumber": "609-573-5310",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "38MC00702600",
"LicenseNumberStateCode": "NJ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}