{
"Npi": {
"NPI": "1245309723",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHRISOL CARE HOME",
"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": "17316 W TARA LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SURPRISE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85388-1216",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "623-266-0552",
"MailingAddressFaxNumber": "623-266-0552",
"FirstLinePracticeLocationAddress": "17316 W TARA LN",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SURPRISE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85388-1216",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "623-266-0552",
"PracticeLocationAddressFaxNumber": "623-266-0552",
"EnumerationDate": "11/07/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANAS",
"AuthorizedOfficialFirstName": "CHRISTINA",
"AuthorizedOfficialMiddleName": "ALAGABAN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ASSISTEDLIVING",
"AuthorizedOfficialTelephoneNumber": "623-266-0552",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "ALH5940",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}