{
"Npi": {
"NPI": "1437587987",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEALTHY LIFE CENTER INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4229 BARDSTOWN RD STE 320",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOUISVILLE",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "40218-3281",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "502-491-8073",
"MailingAddressFaxNumber": "502-491-8773",
"FirstLinePracticeLocationAddress": "4229 BARDSTOWN RD STE 320",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOUISVILLE",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "40218-3281",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "502-491-8073",
"PracticeLocationAddressFaxNumber": "502-491-8773",
"EnumerationDate": "10/18/2013",
"LastUpdateDate": "11/14/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLAUSE",
"AuthorizedOfficialFirstName": "DENNIS",
"AuthorizedOfficialMiddleName": "E",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C",
"AuthorizedOfficialTelephoneNumber": "502-491-8073",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "39868",
"LicenseNumberStateCode": "KY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}