{
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"OrgName": "LIDO WELLNESS CENTER",
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"FirstLineMailingAddress": "3419 VIA LIDO # 313",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWPORT BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92663-3908",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-633-2821",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3404 VIA LIDO",
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"PracticeLocationAddressCityName": "NEWPORT BEACH",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/09/2018",
"LastUpdateDate": "03/09/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEEDEN",
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"AuthorizedOfficialTelephoneNumber": "949-633-2821",
"Taxonomies": {
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"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}