{
"Npi": {
"NPI": "1467271940",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SOUTHWEST LOUISIANA PRIMARY HEALTH CARE CENTER, INC",
"ParentOrgTIN": null,
"OrgName": "SOUTHWEST LOUISIANA PRIMARY HEALTH CARE 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": "8762 HIGHWAY 182",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OPELOUSAS",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70570-5603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "337-942-3390",
"MailingAddressFaxNumber": "337-942-8866",
"FirstLinePracticeLocationAddress": "7076 HIGHWAY 93",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ARNAUDVILLE",
"PracticeLocationAddressStateName": "LA",
"PracticeLocationAddressPostalCode": "70512-6020",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "337-942-3390",
"PracticeLocationAddressFaxNumber": "337-942-8644",
"EnumerationDate": "10/10/2024",
"LastUpdateDate": "10/10/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LAMOTT",
"AuthorizedOfficialFirstName": "DODIE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "337-942-3390",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QF0400X",
"TaxonomyName": "Federally Qualified Health Center (FQHC)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}