{
"Npi": {
"NPI": "1568903805",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "SKYLARK SENIOR CARE, LLC",
"ParentOrgTIN": null,
"OrgName": "SKYLARK ADH-POWERS FERRY, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "120 INTERSTATE NORTH PARKWAY EAST, SE",
"SecondLineMailingAddress": "SUITE 420",
"MailingAddressCityName": "ATLANTA",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "30339-2164",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "678-741-3900",
"MailingAddressFaxNumber": "678-741-3901",
"FirstLinePracticeLocationAddress": "120 INTERSTATE NORTH PKWY EAST, SE",
"SecondLinePracticeLocationAddress": "SUITE 420",
"PracticeLocationAddressCityName": "ATLANTA",
"PracticeLocationAddressStateName": "GA",
"PracticeLocationAddressPostalCode": "30339-2164",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "678-741-3900",
"PracticeLocationAddressFaxNumber": "678-741-3901",
"EnumerationDate": "03/20/2017",
"LastUpdateDate": "03/20/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MORGENS",
"AuthorizedOfficialFirstName": "EDWIN",
"AuthorizedOfficialMiddleName": "HOWARD",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "770-476-8400",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": "ADC000088",
"LicenseNumberStateCode": "GA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}