{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "STATE OF HAWAII, DEPT OF HEALTH, ADULT MENTAL HEALTH DIVISION",
"LastName": null,
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"NamePrefix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "45-691 KEAAHALA RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANEOHE",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96744-3569",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-233-3775",
"MailingAddressFaxNumber": "808-233-3779",
"FirstLinePracticeLocationAddress": "45-691 KEAAHALA RD",
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"PracticeLocationAddressCityName": "KANEOHE",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-233-3775",
"PracticeLocationAddressFaxNumber": "808-233-3779",
"EnumerationDate": "06/29/2011",
"LastUpdateDate": "06/29/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JONES",
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"AuthorizedOfficialMiddleName": "RL",
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"AuthorizedOfficialCredential": "LCSW",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "3714",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}