{
"Npi": {
"NPI": "1235356890",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EXTENSIONS OF LIVING, L.L.C.",
"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": "209 N 35TH STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOREHEAD",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28557-3103",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-726-2338",
"MailingAddressFaxNumber": "252-514-2770",
"FirstLinePracticeLocationAddress": "209 NO 35TH ST",
"SecondLinePracticeLocationAddress": "SUITE 1 & 5",
"PracticeLocationAddressCityName": "MOREHEAD",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28557-3103",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-728-2338",
"PracticeLocationAddressFaxNumber": "252-514-2770",
"EnumerationDate": "04/18/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ROBINSON",
"AuthorizedOfficialFirstName": "MONIQUE",
"AuthorizedOfficialMiddleName": "ALEXANDRIA",
"AuthorizedOfficialTitle": "BILLING OFFICER STAFF NURSE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ADMINISTRATOR",
"AuthorizedOfficialTelephoneNumber": "252-514-2727",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "HC2541",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}