{
"Npi": {
"NPI": "1760795306",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNIQUE OPPORTUNITIES CASE MANAGEMENT",
"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": "2325 SAN PEDRO NE",
"SecondLineMailingAddress": "SUITE 2D",
"MailingAddressCityName": "ALBUQUERQUE",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87110",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-830-5754",
"MailingAddressFaxNumber": "505-830-6907",
"FirstLinePracticeLocationAddress": "2325 SAN PEDRO DR NE STE 2D",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBUQUERQUE",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87110-4120",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-830-5754",
"PracticeLocationAddressFaxNumber": "505-830-6907",
"EnumerationDate": "07/26/2010",
"LastUpdateDate": "07/26/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DEBACA",
"AuthorizedOfficialFirstName": "DIANA",
"AuthorizedOfficialMiddleName": "Y",
"AuthorizedOfficialTitle": "PROGRAM DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": "I",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "505-830-5754",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}