{
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"NPI": "1184173056",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REDWOOD HEALTHCARE CENTER LLC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "107 W LEMON AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONROVIA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91016-2809",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "626-658-7344",
"MailingAddressFaxNumber": "323-846-5788",
"FirstLinePracticeLocationAddress": "3145 HIGH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OAKLAND",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94619-1839",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "510-533-9970",
"PracticeLocationAddressFaxNumber": "510-398-7264",
"EnumerationDate": "10/03/2016",
"LastUpdateDate": "07/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SOLORZANO",
"AuthorizedOfficialFirstName": "CRYSTAL",
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"AuthorizedOfficialTitle": "MANAGING MEMBER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "323-836-9397",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "020000045",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}