{
"Npi": {
"NPI": "1750617718",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BRENDA'S DEVINE HERITAGE RESIDENTIAL, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 570",
"SecondLineMailingAddress": "307 BRISCOE AVE",
"MailingAddressCityName": "DEVINE",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78016-0570",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "830-665-2000",
"MailingAddressFaxNumber": "830-663-2832",
"FirstLinePracticeLocationAddress": "307 BRISCOE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DEVINE",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78016-3003",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "830-665-2000",
"PracticeLocationAddressFaxNumber": "830-663-2832",
"EnumerationDate": "10/27/2009",
"LastUpdateDate": "10/27/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BURFORD",
"AuthorizedOfficialFirstName": "BRENDA",
"AuthorizedOfficialMiddleName": "JOYCE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LVN",
"AuthorizedOfficialTelephoneNumber": "830-665-2000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3104A0625X",
"TaxonomyName": "Assisted Living Facility (Mental Illness)",
"LicenseNumber": "126697",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}