{
"Npi": {
"NPI": "1194014001",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SERENIY FAMILY CARE HOME",
"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 377",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HARRELLS",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28444-0377",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "910-532-4805",
"MailingAddressFaxNumber": "910-532-2766",
"FirstLinePracticeLocationAddress": "1436 BLAND SCHOOL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARRELLS",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28444-7609",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "910-532-4805",
"PracticeLocationAddressFaxNumber": "910-532-2766",
"EnumerationDate": "03/31/2011",
"LastUpdateDate": "03/31/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FENNELL",
"AuthorizedOfficialFirstName": "ERICA",
"AuthorizedOfficialMiddleName": "TERESA",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "910-337-2590",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "3104A0625X",
"TaxonomyName": "Assisted Living Facility (Mental Illness)",
"LicenseNumber": "FCH-082-017",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "FCH-082-017",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}