{
"Npi": {
"NPI": "1316176266",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOVERNOR'S VILLAGE",
"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": "280 N COMMONS BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MAYFIELD VILLAGE",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44143-1592",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-449-8788",
"MailingAddressFaxNumber": "440-442-8648",
"FirstLinePracticeLocationAddress": "280 N COMMONS BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MAYFIELD VILLAGE",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44143-1592",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "440-449-8788",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/13/2009",
"LastUpdateDate": "07/13/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GORMAN",
"AuthorizedOfficialFirstName": "MICHELLE",
"AuthorizedOfficialMiddleName": "KATHLEEN",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "440-449-8788",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "RCF2332R",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}