{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "NC DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF PUBLIC HEALTH",
"LastName": null,
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"FirstLineMailingAddress": "1914 MAIL SERVICES CENTER",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RALEIGH",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27699-1914",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-707-5800",
"MailingAddressFaxNumber": "919-870-4818",
"FirstLinePracticeLocationAddress": "5601 SIX FORKS RD",
"SecondLinePracticeLocationAddress": "BUILDING 2",
"PracticeLocationAddressCityName": "RALEIGH",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27609-3811",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-707-5800",
"PracticeLocationAddressFaxNumber": "919-870-4818",
"EnumerationDate": "01/15/2010",
"LastUpdateDate": "01/15/2010",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LENIHAN",
"AuthorizedOfficialFirstName": "ALICE",
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"AuthorizedOfficialTitle": "NUTRION SERVICES BRANCH HEAD",
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"AuthorizedOfficialCredential": "MPH,RD",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "332BP3500X",
"TaxonomyName": "Parenteral & Enteral Nutrition Supplies (DME)",
"LicenseNumber": "DME PERMIT 01609",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}