{
"Npi": {
"NPI": "1346544558",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ALICE BOLTON PA",
"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": "2577 EDNOR ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PORT CHARLOTTE",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33952-4335",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "941-629-0282",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2750 BAHIA VISTA,",
"SecondLinePracticeLocationAddress": "STE 108",
"PracticeLocationAddressCityName": "SARASOTA",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "34239-2636",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "941-954-1101",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/03/2011",
"LastUpdateDate": "01/03/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BOLTON",
"AuthorizedOfficialFirstName": "ALICE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ARNP,MS,CS,BC",
"AuthorizedOfficialTelephoneNumber": "941-629-0282",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "ARNP478692",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}