{
"Npi": {
"NPI": "1376917195",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIVE CHANGE GROW CORPORATION",
"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": "1700 W MARKET ST",
"SecondLineMailingAddress": "NUM 190",
"MailingAddressCityName": "AKRON",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44313-7002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "216-242-9174",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1440 VIRGINIA AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AKRON",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44306-3610",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "216-242-9174",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/17/2015",
"LastUpdateDate": "11/17/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TURNER",
"AuthorizedOfficialFirstName": "KIMYATTA",
"AuthorizedOfficialMiddleName": "K",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RHIA, MBA",
"AuthorizedOfficialTelephoneNumber": "216-242-9174",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}