{
"Npi": {
"NPI": "1700261633",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHINE SENIOR CENTER",
"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": "9198 RED BRANCH RD STE H",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COLUMBIA",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21045-2017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "301-310-3067",
"MailingAddressFaxNumber": "410-772-3933",
"FirstLinePracticeLocationAddress": "9198 RED BRANCH RD STE H",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "COLUMBIA",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21045-2017",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "301-310-3067",
"PracticeLocationAddressFaxNumber": "410-772-3933",
"EnumerationDate": "07/21/2015",
"LastUpdateDate": "07/21/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LEE",
"AuthorizedOfficialFirstName": "SEONGBOK",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "301-821-7214",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QA0600X",
"TaxonomyName": "Adult Day Care Clinic/Center",
"LicenseNumber": "TBA",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}