{
"Npi": {
"NPI": "1386974582",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DEIRDRE'S VINTAGE HOUSE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "27277 BAGLEY RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OLMSTED FALLS",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44138-1001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "440-476-8905",
"MailingAddressFaxNumber": "440-793-6359",
"FirstLinePracticeLocationAddress": "27277 BAGLEY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OLMSTED FALLS",
"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "440-476-8905",
"PracticeLocationAddressFaxNumber": "440-793-6359",
"EnumerationDate": "01/11/2010",
"LastUpdateDate": "01/11/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEWMAN",
"AuthorizedOfficialFirstName": "DEIRDRE",
"AuthorizedOfficialMiddleName": "FAITH",
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "L.P.N.",
"AuthorizedOfficialTelephoneNumber": "440-476-8905",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "3270AGH",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}