{
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"FirstLineMailingAddress": "1504 MADISON ST",
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"MailingAddressStateName": "NE",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "1314 GALVIN RD S",
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"EnumerationDate": "03/05/2025",
"LastUpdateDate": "03/05/2025",
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"NPIReactivationDate": null,
"GenderCode": null,
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"AuthorizedOfficialLastName": "OLSON",
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"Taxonomies": {
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"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}