{
"Npi": {
"NPI": "1235420852",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CORNERSTONE HEALTH SERVICES, INC-",
"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": "512 COTTAGE PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERDALE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30274-2408",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "770-471-7320",
"MailingAddressFaxNumber": "770-471-9057",
"FirstLinePracticeLocationAddress": "512 COTTAGE PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RIVERDALE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30274-2408",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "770-471-7320",
"PracticeLocationAddressFaxNumber": "770-471-9057",
"EnumerationDate": "04/30/2011",
"LastUpdateDate": "04/30/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DANIELS",
"AuthorizedOfficialFirstName": "SANDRA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "770-471-7320",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QD1600X",
"TaxonomyName": "Developmental Disabilities Clinic/Center",
"LicenseNumber": "031011501",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}