{
"Npi": {
"NPI": "1194043968",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SEED CENTER ROSWELL REHABILITATION ADDICTION PROGRAM",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1659 WASHINGTON BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANSAS CITY",
"MailingAddressStateName": "KS",
"MailingAddressPostalCode": "66102-2841",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "913-233-2223",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1659 WASHINGTON BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "KANSAS CITY",
"PracticeLocationAddressStateName": "KS",
"PracticeLocationAddressPostalCode": "66102-2841",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "913-233-2223",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/04/2010",
"LastUpdateDate": "05/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PORTER",
"AuthorizedOfficialFirstName": "ALAN",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "CLINICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSW",
"AuthorizedOfficialTelephoneNumber": "573-823-0283",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QR0800X",
"TaxonomyName": "Recovery Care Clinic/Center",
"LicenseNumber": "07070894",
"LicenseNumberStateCode": "KS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}