{
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"EIN": null,
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"IsOrgSubpart": "Y",
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"OrgName": "LDS FAMILY SERVICES",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "1100 W JACKSON RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CARROLLTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75006-1316",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "972-242-2182",
"MailingAddressFaxNumber": "972-242-2932",
"FirstLinePracticeLocationAddress": "1100 W JACKSON RD",
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"PracticeLocationAddressCityName": "CARROLLTON",
"PracticeLocationAddressStateName": "TX",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "972-242-2182",
"PracticeLocationAddressFaxNumber": "972-242-2932",
"EnumerationDate": "02/28/2007",
"LastUpdateDate": "06/06/2008",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FERNELIUS",
"AuthorizedOfficialFirstName": "ERIC",
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"AuthorizedOfficialTitle": "DIRECTOR",
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"AuthorizedOfficialCredential": "LCSW",
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"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0801X",
"TaxonomyName": "Mental Health Clinic/Center (Including Community Mental Health Center)",
"LicenseNumber": "497",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}