{
"Npi": {
"NPI": "1659216265",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DTAC OF CRANBERRY 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": "411 OLD BALTIMORE PIKE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CHADDS FORD",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "19317-9485",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "9528 GOEHRING ROAD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CRANBERRY TOWNSHIP",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "16066",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "724-513-4312",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/21/2026",
"LastUpdateDate": "04/21/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LYLES",
"AuthorizedOfficialFirstName": "JESSICA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CHIEF BUSINESS OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MBA",
"AuthorizedOfficialTelephoneNumber": "561-871-9569",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "323P00000X",
"TaxonomyName": "Psychiatric Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}