{
"Npi": {
"NPI": "1184052920",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIFE SKILLS OCCUPATIONAL THERAPY",
"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": "PO BOX 7",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LEITCHFIELD",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "42755-0007",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "308 W MARKET ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LEITCHFIELD",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "42754-1265",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "270-589-1292",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/14/2013",
"LastUpdateDate": "11/08/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EARLEY",
"AuthorizedOfficialFirstName": "DANA",
"AuthorizedOfficialMiddleName": "R",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSOT, OTR/L",
"AuthorizedOfficialTelephoneNumber": "270-589-1292",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0400X",
"TaxonomyName": "Rehabilitation Clinic/Center",
"LicenseNumber": "R4652",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}