{
"Npi": {
"NPI": "1518108430",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EPIC SUPPORTS AND SERVICES",
"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": "602 CIRCLE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27858-8508",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "252-341-2397",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "99 N MAIN ST",
"SecondLinePracticeLocationAddress": "2ND FLOOR OFFICE #1",
"PracticeLocationAddressCityName": "TARBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27886-5056",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "252-641-1620",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/23/2009",
"LastUpdateDate": "03/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TAYLOR",
"AuthorizedOfficialFirstName": "ERNESTINE",
"AuthorizedOfficialMiddleName": "SMITH",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "252-341-2397",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "261QM0855X",
"TaxonomyName": "Adolescent and Children Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}