{
"Npi": {
"NPI": "1598314619",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELDORADO WEST SENIOR LIVING",
"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": "6628 MYRTLE BEACH DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75093-6302",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-718-1120",
"MailingAddressFaxNumber": "972-307-5385",
"FirstLinePracticeLocationAddress": "3051 W ELDORADO PKWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LITTLE ELM",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75068-3537",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "469-777-3151",
"PracticeLocationAddressFaxNumber": "972-307-5385",
"EnumerationDate": "09/11/2019",
"LastUpdateDate": "09/11/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARK",
"AuthorizedOfficialFirstName": "CHAN YOUNG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "214-718-1120",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3104A0630X",
"TaxonomyName": "Assisted Living Facility (Behavioral Disturbances)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}