{
"Npi": {
"NPI": "1649049081",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SMALLTOWN OPPORTUNITIES INC",
"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": "1087 UPPER SECOND CREEK RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAZARD",
"MailingAddressStateName": "KY",
"MailingAddressPostalCode": "41701-9527",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "606-216-4940",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1087 UPPER SECOND CREEK RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HAZARD",
"PracticeLocationAddressStateName": "KY",
"PracticeLocationAddressPostalCode": "41701-9527",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "606-216-4940",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/27/2023",
"LastUpdateDate": "12/27/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHIELDS",
"AuthorizedOfficialFirstName": "ROSE",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BS",
"AuthorizedOfficialTelephoneNumber": "606-216-4940",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "320900000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}