{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "COPPER RIVER CARE ASSISTED LIVING HOME",
"LastName": null,
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"NamePrefix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 866",
"SecondLineMailingAddress": "3/4 MILE RIDGE ROAD",
"MailingAddressCityName": "SALANA",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99586",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-822-4255",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3/4 MILE RIDGE ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SALANA",
"PracticeLocationAddressStateName": "AK",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-822-4255",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/15/2010",
"LastUpdateDate": "03/09/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WEBB",
"AuthorizedOfficialFirstName": "ANGELIA",
"AuthorizedOfficialMiddleName": "RAY",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "907-822-4255",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "921585",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}