{
"Npi": {
"NPI": "1619305760",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MENTAL HEALTH SERVICES",
"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": "5394 SIERRA RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN BERNARDINO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92407-3241",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-918-7241",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5394 SIERRA RD",
"SecondLinePracticeLocationAddress": "1874 BUSINESS CENTER DR SAN BERNARDINO CA 92408",
"PracticeLocationAddressCityName": "SAN BERNARDINO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92407-3241",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-918-7241",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/29/2013",
"LastUpdateDate": "10/29/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HOBSON",
"AuthorizedOfficialFirstName": "VICKI",
"AuthorizedOfficialMiddleName": "MICHELLE",
"AuthorizedOfficialTitle": "DRUG AND ALCOHOL COUNSELOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "909-918-7241",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "276400000X",
"TaxonomyName": "Substance Use Disorder Rehabilitation Hospital Unit",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}