{
"Npi": {
"NPI": "1629996939",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UP NEXT DIRECT LLC",
"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": "400 CONTINENTAL BLVD STE 6084",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL SEGUNDO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90245-5076",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "323-353-8154",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1601 W 165TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COMPTON",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90220-4315",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "323-353-8154",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/07/2026",
"LastUpdateDate": "07/07/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEAVERS",
"AuthorizedOfficialFirstName": "TAMELA",
"AuthorizedOfficialMiddleName": "BONESHA",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "323-353-8154",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}