{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "ON TRACK REHABILITATION, LLC",
"LastName": null,
"FirstName": null,
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"FirstLineMailingAddress": "3702 BRENBROOK DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RANDALLSTOWN",
"MailingAddressStateName": "MD",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "443-415-0004",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "8839 KELSO DR",
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"PracticeLocationAddressCityName": "ESSEX",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/19/2015",
"LastUpdateDate": "01/19/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOGAN",
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"AuthorizedOfficialCredential": "P.T.",
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"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
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},
{
"TaxonomyCode": "261QH0100X",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}