{
"Npi": {
"NPI": "1255797163",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INSIGHT BEHAVIORAL HEALTH, 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": "14156 MAGNOLIA BLVD",
"SecondLineMailingAddress": "STE 101",
"MailingAddressCityName": "SHERMAN OAKS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91423-1181",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-501-3512",
"MailingAddressFaxNumber": "818-501-7148",
"FirstLinePracticeLocationAddress": "769 N ORANGE GROVE BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PASADENA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91103-3331",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "626-564-2703",
"PracticeLocationAddressFaxNumber": "626-564-2707",
"EnumerationDate": "01/07/2016",
"LastUpdateDate": "01/07/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOPEZ",
"AuthorizedOfficialFirstName": "ANTHONY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER/ CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-501-3512",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}