{
"Npi": {
"NPI": "1548607393",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CALIFORNIA CORRECTIONAL HEALTH CARE 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": "8280 LONG LEAF DRIVE, BLDG D-172",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ELK GROVE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "95758",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "916-691-6150",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8280 LONG LEAF DRIVE",
"SecondLinePracticeLocationAddress": "BLDG D-172",
"PracticeLocationAddressCityName": "ELK GROVE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "95758",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "916-691-6150",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/03/2013",
"LastUpdateDate": "06/03/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REKART",
"AuthorizedOfficialFirstName": "JOHN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF OF MENTAL HEALTH",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MD",
"AuthorizedOfficialTelephoneNumber": "916-691-6150",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "276400000X",
"TaxonomyName": "Substance Use Disorder Rehabilitation Hospital Unit",
"LicenseNumber": "A26603",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}