{
"Npi": {
"NPI": "1629419239",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHEPHERD OF THE VALLEY LUTHERAN RETIREMENT SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "5525 SILICA RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "AUSTINTOWN",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44515-1002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-530-4038",
"MailingAddressFaxNumber": "330-530-4039",
"FirstLinePracticeLocationAddress": "301 W WESTERN RESERVE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "POLAND",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44514-3527",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-726-7110",
"PracticeLocationAddressFaxNumber": "330-726-2517",
"EnumerationDate": "07/11/2013",
"LastUpdateDate": "07/11/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN",
"AuthorizedOfficialFirstName": "VICTORIA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ASSOCIATE DIRECTOR/C.F.O.",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "C.F.O.",
"AuthorizedOfficialTelephoneNumber": "330-530-4038",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "5184",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}