{
"Npi": {
"NPI": "1265325740",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OUTREACH REDEMPTION, CORP",
"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": "9203 FAIRWAY CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERDALE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30274-4674",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-454-5660",
"MailingAddressFaxNumber": "404-454-5660",
"FirstLinePracticeLocationAddress": "157 BURKE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STOCKBRIDGE",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30281-3433",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "470-521-5495",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/02/2025",
"LastUpdateDate": "09/21/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "JENNIFER",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "THERAPIST/EDUCATOR",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "EDD",
"AuthorizedOfficialTelephoneNumber": "404-454-5660",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}