{
"Npi": {
"NPI": "1699919928",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BACK ON CALL, 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": "197 GREAT OAKS TRL # 140",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "WADSWORTH",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44281-8215",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-335-4804",
"MailingAddressFaxNumber": "330-335-4806",
"FirstLinePracticeLocationAddress": "197 GREAT OAKS TRL # 140",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WADSWORTH",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44281-8215",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-335-4804",
"PracticeLocationAddressFaxNumber": "330-335-4806",
"EnumerationDate": "04/30/2009",
"LastUpdateDate": "04/30/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BACK",
"AuthorizedOfficialFirstName": "SHERYL",
"AuthorizedOfficialMiddleName": "LYNN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.N.S., CCC-SLP",
"AuthorizedOfficialTelephoneNumber": "330-335-4804",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": "SP-4804",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}