{
"Npi": {
"NPI": "1528260478",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DIAMANTINA OLIVARES DBA GENESIS ADULT DAY CARE",
"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": "2820 W EXPRESSWAY 83",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALMVIEW",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78572-8755",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "956-583-6967",
"MailingAddressFaxNumber": "956-583-0484",
"FirstLinePracticeLocationAddress": "2820 W EXPRESSWAY 83",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PALMVIEW",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78572-8755",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "956-583-6967",
"PracticeLocationAddressFaxNumber": "956-583-0484",
"EnumerationDate": "06/04/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OLIVAREZ",
"AuthorizedOfficialFirstName": "DIAMANTINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "956-583-6967",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": "119209",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}