{
"Npi": {
"NPI": "1275082851",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NOLA INTERVENTION, 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": "4300 S I 10 SERVICE RD W",
"SecondLineMailingAddress": "103L",
"MailingAddressCityName": "METAIRIE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70001-7405",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "4300 S I 10 SERVICE RD W",
"SecondLinePracticeLocationAddress": "103L",
"PracticeLocationAddressCityName": "METAIRIE",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70001-7405",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-602-7614",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/23/2016",
"LastUpdateDate": "09/23/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIXSON",
"AuthorizedOfficialFirstName": "ADRIENNE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PH.D.",
"AuthorizedOfficialTelephoneNumber": "614-602-7614",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "10719742#2NJ62",
"LicenseNumberStateCode": "LA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}