{
"Npi": {
"NPI": "1487126066",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SKYLARK ADH-ATLANTA LLC",
"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": "4265 JOHNS CREEK PKWY STE B",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SUWANEE",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30024-6038",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "404-410-1510",
"MailingAddressFaxNumber": "678-646-0602",
"FirstLinePracticeLocationAddress": "1705 COMMERCE DR NW STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30318-3107",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "404-410-1510",
"PracticeLocationAddressFaxNumber": "678-646-0602",
"EnumerationDate": "12/20/2018",
"LastUpdateDate": "12/20/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MORGENS",
"AuthorizedOfficialFirstName": "EDWIN",
"AuthorizedOfficialMiddleName": "HOWARD",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "404-410-1510",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}