{
"Npi": {
"NPI": "1255878401",
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RESILIENCE HEALTH SYSTEMS CORPORATION",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "25701 N LAKELAND BLVD",
"SecondLineMailingAddress": "SUITE 300",
"MailingAddressCityName": "EUCLID",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44132-2450",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "216-261-6398",
"MailingAddressFaxNumber": "440-525-5564",
"FirstLinePracticeLocationAddress": "25701 N LAKELAND BLVD",
"SecondLinePracticeLocationAddress": "SUITE 300",
"PracticeLocationAddressCityName": "EUCLID",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44132-2450",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-261-6398",
"PracticeLocationAddressFaxNumber": "440-525-5564",
"EnumerationDate": "01/26/2017",
"LastUpdateDate": "01/27/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SIDARI",
"AuthorizedOfficialFirstName": "BONNIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MEDICAL DIRECTOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.O.",
"AuthorizedOfficialTelephoneNumber": "216-261-6398",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM1300X",
"TaxonomyName": "Multi-Specialty Clinic/Center",
"LicenseNumber": "34006458",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}