{
"Npi": {
"NPI": "1316089030",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SENIOR LIFE, INC.",
"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": "P.O. BOX 8359",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ST. JOSEPH",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "64508-8359",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "816-232-9874",
"MailingAddressFaxNumber": "816-364-4454",
"FirstLinePracticeLocationAddress": "1616 WEISENBORN RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAINT JOSEPH",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "64507-2527",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "816-232-9874",
"PracticeLocationAddressFaxNumber": "816-364-4454",
"EnumerationDate": "02/12/2007",
"LastUpdateDate": "12/11/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAXTON",
"AuthorizedOfficialFirstName": "TIMOTHY",
"AuthorizedOfficialMiddleName": "DELMAR",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "816-364-2578",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "033685",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "313M00000X",
"TaxonomyName": "Nursing Facility/Intermediate Care Facility",
"LicenseNumber": "033652",
"LicenseNumberStateCode": "MO",
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}