{
"Npi": {
"NPI": "1700083656",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADEOLA MUSTAPHA",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3352 SEDONA DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND PRAIRIE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75052-8401",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-522-0836",
"MailingAddressFaxNumber": "972-522-0834",
"FirstLinePracticeLocationAddress": "3352 SEDONA DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND PRAIRIE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75052-8401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-522-0836",
"PracticeLocationAddressFaxNumber": "972-522-0834",
"EnumerationDate": "07/02/2007",
"LastUpdateDate": "01/29/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MUSTAPHA",
"AuthorizedOfficialFirstName": "BOLANLE",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "ASS. ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "214-213-5464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "010765",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}