{
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"OrgName": "CROSSING THE JORDAN CHRISTIAN HEALTH CENTER, INC.",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "289 E BEAU ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WASHINGTON",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15301-4710",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "724-222-7159",
"MailingAddressFaxNumber": "724-222-7169",
"FirstLinePracticeLocationAddress": "289 E BEAU ST",
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"PracticeLocationAddressCityName": "WASHINGTON",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "724-222-7159",
"PracticeLocationAddressFaxNumber": "724-222-7169",
"EnumerationDate": "02/03/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FALCIONE",
"AuthorizedOfficialFirstName": "MICHAEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
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"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "724-222-7159",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Primary Care Clinic/Center",
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"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}