{
"Npi": {
"NPI": "1235826215",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COOPERS CORNER, 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": "7939 HONEYGO BLVD STE 124",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NOTTINGHAM",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21236-5991",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "862-235-5755",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "11 MILL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW ROCHELLE",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10804-2118",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "914-819-5370",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/20/2023",
"LastUpdateDate": "04/20/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EVEGAN",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "REGIONAL DIRECTOR OF OPERATIONS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "862-235-5755",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}