{
"Npi": {
"NPI": "1295248623",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TLC GUEST HOME, 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": "733 W CARSON ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TORRANCE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90502-2106",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "702-502-7632",
"MailingAddressFaxNumber": "702-359-2388",
"FirstLinePracticeLocationAddress": "1700 248TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOMITA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90717-1333",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "424-263-5385",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/07/2017",
"LastUpdateDate": "11/07/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOMONDON",
"AuthorizedOfficialFirstName": "MARY ALYN",
"AuthorizedOfficialMiddleName": "ABAD",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DIRECTOR",
"AuthorizedOfficialTelephoneNumber": "424-263-5385",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}