{
"Npi": {
"NPI": "1578746103",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTH COUNTY SERENITY HOUSE,INC.",
"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": "130 S FIG ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ESCONDIDO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92025-4401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "760-415-5609",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "240 S HICKORY ST STE 210",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ESCONDIDO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92025-4357",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "760-233-4533",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/05/2007",
"LastUpdateDate": "12/05/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOELK",
"AuthorizedOfficialFirstName": "NORMA",
"AuthorizedOfficialMiddleName": "SUZANNE",
"AuthorizedOfficialTitle": "PROGRAM DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "760-741-5098",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "324500000X",
"TaxonomyName": "Substance Abuse Rehabilitation Facility",
"LicenseNumber": "01-980444",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}