{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "GENESIS REHAB SERVICES",
"LastName": null,
"FirstName": null,
"MiddleName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "809 ADDISON CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VIRGINIA BEACH",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23462-6904",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-463-0670",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "809 ADDISON CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VIRGINIA BEACH",
"PracticeLocationAddressStateName": "VA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "757-463-0670",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/21/2009",
"LastUpdateDate": "04/21/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILSON-HAMMOND",
"AuthorizedOfficialFirstName": "CHARISE",
"AuthorizedOfficialMiddleName": "LILLIAN",
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"AuthorizedOfficialCredential": "OTR/L",
"AuthorizedOfficialTelephoneNumber": "757-463-0670",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "0119004820",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}