{
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"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "1820 W MOLINE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MALVERN",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "501-337-9581",
"MailingAddressFaxNumber": "501-337-9168",
"FirstLinePracticeLocationAddress": "1820 W MOLINE ST",
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"PracticeLocationAddressTelephoneNumber": "501-337-9581",
"PracticeLocationAddressFaxNumber": "501-337-9168",
"EnumerationDate": "11/01/2006",
"LastUpdateDate": "02/20/2015",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCMORRIS",
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"AuthorizedOfficialTelephoneNumber": "225-769-7960",
"Taxonomies": {
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"TaxonomyName": "Skilled Nursing Facility",
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}
},
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}
}