{
"Npi": {
"NPI": "1780857847",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAGELLAN HEALTH SERVICES",
"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": "1035 E JEFFERSON ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "PHOENIX",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85034-2295",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "602-252-6731",
"MailingAddressFaxNumber": "602-252-5928",
"FirstLinePracticeLocationAddress": "1035 E JEFFERSON ST",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "PHOENIX",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85034-2295",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "602-252-6731",
"PracticeLocationAddressFaxNumber": "602-252-5928",
"EnumerationDate": "04/10/2008",
"LastUpdateDate": "04/10/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KING",
"AuthorizedOfficialFirstName": "LATANYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "COUNSELOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LISAC0821",
"AuthorizedOfficialTelephoneNumber": "602-252-6731",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": "LISAC0821",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}