{
"Npi": {
"NPI": "1265615462",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HUNTSVILLE CLINIC, 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": "829 10TH ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HUNTSVILLE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77320-4721",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "936-291-9172",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "829 10TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HUNTSVILLE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77320-4721",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "936-291-9172",
"PracticeLocationAddressFaxNumber": "936-291-7156",
"EnumerationDate": "12/11/2007",
"LastUpdateDate": "04/20/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRIS",
"AuthorizedOfficialFirstName": "STACEY",
"AuthorizedOfficialMiddleName": "RAE",
"AuthorizedOfficialTitle": "CEO/PROGRAM SPONSOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.C.D.C.",
"AuthorizedOfficialTelephoneNumber": "936-524-2140",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM2800X",
"TaxonomyName": "Methadone Clinic",
"LicenseNumber": "TX10096M",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}