{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "MACEDONIA FAMILY AND COMMUNITY ENRICHMENT CENTER, INC",
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"NamePrefix": null,
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"FirstLineMailingAddress": "2226 BEDFORD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PITTSBURGH",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "15219-4056",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "412-281-2573",
"MailingAddressFaxNumber": "412-281-3854",
"FirstLinePracticeLocationAddress": "2851 BEDFORD AVE STE 3",
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"PracticeLocationAddressCityName": "PITTSBURGH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "412-687-8004",
"PracticeLocationAddressFaxNumber": "412-687-6950",
"EnumerationDate": "07/28/2008",
"LastUpdateDate": "07/28/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
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"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
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"AuthorizedOfficialCredential": "LCSW,BCD",
"AuthorizedOfficialTelephoneNumber": "412-281-2573",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "CW012711",
"LicenseNumberStateCode": "PA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}