{
"Npi": {
"NPI": "1457451627",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMMUNITY ACTION SOUTH EASTERN WV",
"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": "307 FEDERAL ST",
"SecondLineMailingAddress": "SUITE 323",
"MailingAddressCityName": "BLUEFIELD",
"MailingAddressStateName": "WV",
"MailingAddressPostalCode": "24701-3063",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "304-327-3506",
"MailingAddressFaxNumber": "304-327-8822",
"FirstLinePracticeLocationAddress": "307 FEDERAL ST",
"SecondLinePracticeLocationAddress": "SUITE 323",
"PracticeLocationAddressCityName": "BLUEFIELD",
"PracticeLocationAddressStateName": "WV",
"PracticeLocationAddressPostalCode": "24701-3063",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "304-323-8398",
"PracticeLocationAddressFaxNumber": "304-324-8791",
"EnumerationDate": "09/25/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JOHNSON",
"AuthorizedOfficialFirstName": "BRENDA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PROGRAM DIRECTOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "304-323-8398",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}