{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOLDEN ELDERLY CARE SUITES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1066 SHERWOOD RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHOREVIEW",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55126-8429",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "763-447-7717",
"MailingAddressFaxNumber": "651-484-5130",
"FirstLinePracticeLocationAddress": "4624 STODDART CIRCLE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WHITE BEAR LAKE",
"PracticeLocationAddressStateName": "MN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "763-447-7717",
"PracticeLocationAddressFaxNumber": "651-484-5130",
"EnumerationDate": "06/14/2016",
"LastUpdateDate": "06/14/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STRANDLUND",
"AuthorizedOfficialFirstName": "NANCY",
"AuthorizedOfficialMiddleName": "HUELMA",
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"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "763-447-7717",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "373034",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}