{
"Npi": {
"NPI": "1285136275",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ASSURED CARE ALF",
"ParentOrgTIN": null,
"OrgName": "ASSURED CARE ALF",
"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": "10004 COUNTRY CARRIAGE CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RIVERVIEW",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33569-5694",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "813-239-7558",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2006 WRANGLER DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRANDON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33511-2121",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "813-239-7558",
"PracticeLocationAddressFaxNumber": "813-571-9909",
"EnumerationDate": "03/06/2018",
"LastUpdateDate": "03/06/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HILSMAN",
"AuthorizedOfficialFirstName": "CARMELA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "813-239-7558",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "AL13136",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}