{
"Npi": {
"NPI": "1457545873",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "RESURRECTION POWER INC.",
"ParentOrgTIN": null,
"OrgName": "SOUTHERN BLOSSOM",
"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": "378 N LAKE BLVD",
"SecondLineMailingAddress": "SUITE 120",
"MailingAddressCityName": "NORTH PALM BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33408-5421",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-633-2448",
"MailingAddressFaxNumber": "561-682-1947",
"FirstLinePracticeLocationAddress": "4308 HUNTING TRL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LAKE WORTH",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33467-3504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-633-2448",
"PracticeLocationAddressFaxNumber": "561-682-1947",
"EnumerationDate": "08/29/2007",
"LastUpdateDate": "09/06/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
"AuthorizedOfficialFirstName": "DAHLIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "C.E.O.",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "561-633-2448",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}