{
"Npi": {
"NPI": "1497040117",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HILLSBOROUGH MANOR INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2893 EL CAMINO REAL, STE. C",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDWOOD CITY",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94061",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "650-216-9960",
"MailingAddressFaxNumber": "650-216-9455",
"FirstLinePracticeLocationAddress": "1776 ADAMS ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SAN MATEO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "94403-1108",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "650-578-1091",
"PracticeLocationAddressFaxNumber": "650-216-9455",
"EnumerationDate": "06/10/2011",
"LastUpdateDate": "06/10/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VERIDIANO",
"AuthorizedOfficialFirstName": "ROSEMARIE",
"AuthorizedOfficialMiddleName": "TAMBOT",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHARMACIST",
"AuthorizedOfficialTelephoneNumber": "650-580-2983",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "315P00000X",
"TaxonomyName": "Intellectual Disabilities Intermediate Care Facility",
"LicenseNumber": "315P00000X",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}