{
"Npi": {
"NPI": "1346470135",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SEASHORE POINT",
"ParentOrgTIN": null,
"OrgName": "SEASHORE POINT WELLNESS AND REHAB",
"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": "100 ALDEN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PROVINCETOWN",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "02657-1456",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "508-487-7777",
"MailingAddressFaxNumber": "508-487-7706",
"FirstLinePracticeLocationAddress": "100 ALDEN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PROVINCETOWN",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02657-1456",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "508-487-7777",
"PracticeLocationAddressFaxNumber": "508-487-7706",
"EnumerationDate": "07/15/2009",
"LastUpdateDate": "07/15/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTMINY",
"AuthorizedOfficialFirstName": "CRAIG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "REHAB MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OTR/L",
"AuthorizedOfficialTelephoneNumber": "508-487-7777",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "11096",
"LicenseNumberStateCode": "MA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}