{
"Npi": {
"NPI": "1760226245",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BECKET MAINE INC.",
"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": "PO BOX 325",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ORFORD",
"MailingAddressStateName": "NH",
"MailingAddressPostalCode": "03777-0325",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "603-353-9102",
"MailingAddressFaxNumber": "603-353-9412",
"FirstLinePracticeLocationAddress": "744 OAKLAND RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BELGRADE",
"PracticeLocationAddressStateName": "ME",
"PracticeLocationAddressPostalCode": "04917-3411",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "603-353-9102",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/20/2024",
"LastUpdateDate": "06/20/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOLTER",
"AuthorizedOfficialFirstName": "JAY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "603-353-9102",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "320800000X",
"TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "322D00000X",
"TaxonomyName": "Emotionally Disturbed Childrens' Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}