{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "DR. HARRIS - MISSION GROVE CHIROPRACTIC, INC",
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"FirstLineMailingAddress": "6670 ALESSANDRO BLVD",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "RIVERSIDE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92506-5356",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "951-776-1693",
"MailingAddressFaxNumber": "951-776-1694",
"FirstLinePracticeLocationAddress": "6670 ALESSANDRO BLVD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "951-776-1693",
"PracticeLocationAddressFaxNumber": "951-776-1694",
"EnumerationDate": "05/24/2016",
"LastUpdateDate": "05/24/2016",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRIS",
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"AuthorizedOfficialTitle": "DIRECTOR",
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"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "951-776-1693",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Chiropractor",
"LicenseNumber": "DC27441",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}