{
"Npi": {
"NPI": "1437300506",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ABC THERAPY, INC.",
"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": "3003 HIGHWAY 95",
"SecondLineMailingAddress": "SUITE N-104",
"MailingAddressCityName": "BULLHEAD CITY",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "86442-7860",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "928-763-0250",
"MailingAddressFaxNumber": "928-763-0271",
"FirstLinePracticeLocationAddress": "3003 HIGHWAY 95",
"SecondLinePracticeLocationAddress": "SUITE N-104",
"PracticeLocationAddressCityName": "BULLHEAD CITY",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "86442-7860",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "928-763-0250",
"PracticeLocationAddressFaxNumber": "928-763-0271",
"EnumerationDate": "10/07/2008",
"LastUpdateDate": "10/07/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ARCHER",
"AuthorizedOfficialFirstName": "PATRICIA",
"AuthorizedOfficialMiddleName": "A.",
"AuthorizedOfficialTitle": "COUNSELOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "THERAPIST",
"AuthorizedOfficialTelephoneNumber": "928-763-0250",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "305R00000X",
"TaxonomyName": "Preferred Provider Organization",
"LicenseNumber": "BH-3065",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}