{
"Npi": {
"NPI": "1255053336",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FORCES FOR CHANGE LLC",
"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": "822 N SHERIDAN AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURGH",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15206-2211",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-966-6631",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "211 N WHITFIELD ST STE 300A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PITTSBURGH",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "15206-3039",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-966-6631",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/14/2022",
"LastUpdateDate": "09/14/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEDFORD-JACK",
"AuthorizedOfficialFirstName": "EMMA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CO-OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW",
"AuthorizedOfficialTelephoneNumber": "860-966-6631",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}