{
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"FirstLineMailingAddress": "1811 S QUEBEC WAY",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1811 S QUEBEC WAY",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/31/2018",
"LastUpdateDate": "12/09/2020",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GETAHUN",
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"AuthorizedOfficialTelephoneNumber": "303-269-1746",
"Taxonomies": {
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"TaxonomyName": "Non-emergency Medical Transport (VAN)",
"LicenseNumber": null,
"LicenseNumberStateCode": "CO",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}