{
"Npi": {
"NPI": "1215091152",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DANFORTH ADULT CARE CENTER",
"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": "23 COMPUTER DR E",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "12205-1276",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "518-459-0786",
"MailingAddressFaxNumber": "518-459-0775",
"FirstLinePracticeLocationAddress": "19 DANFORTH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOOSICK FALLS",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "12090-1223",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "518-686-5167",
"PracticeLocationAddressFaxNumber": "518-686-4428",
"EnumerationDate": "12/21/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAZULA",
"AuthorizedOfficialFirstName": "GLENN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "518-459-0786",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "0815L001",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}