{
"Npi": {
"NPI": "1306988530",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LONG ACRES FAMILY CARE HOME #2",
"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": "1133 VILLA GREEN CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RALEIGH",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27612-2488",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "919-676-8062",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "404 PARNELL DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RALEIGH",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27610-3402",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "919-231-1404",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "THOMPSON",
"AuthorizedOfficialFirstName": "RANSFORD",
"AuthorizedOfficialMiddleName": "NYLANDER",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "919-795-8338",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "FCL-092-026",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}