{
"Npi": {
"NPI": "1275989683",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SENIOR SUITES AT WOODSIDE VILLAGE, 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": "8170 MCCORMICK BLVD",
"SecondLineMailingAddress": "SUITE 220",
"MailingAddressCityName": "SKOKIE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60076-2961",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-763-1111",
"MailingAddressFaxNumber": "847-423-6991",
"FirstLinePracticeLocationAddress": "19455 ROCKSIDE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BEDFORD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44146-2000",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "440-359-6139",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "05/04/2016",
"LastUpdateDate": "05/05/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STESEL",
"AuthorizedOfficialFirstName": "MAX",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "847-942-7575",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}