{
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"FirstLineMailingAddress": "901 COURY RD",
"SecondLineMailingAddress": "APT#19",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1807 LOST CROSSING TRL",
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"EnumerationDate": "10/26/2011",
"LastUpdateDate": "10/26/2011",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "MOORE",
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"Taxonomies": {
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"TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}