{
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"FirstLineMailingAddress": "610 THIMBLE SHOALS BLVD STE 403",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWPORT NEWS",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23606-2573",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "757-534-7840",
"MailingAddressFaxNumber": "757-534-7844",
"FirstLinePracticeLocationAddress": "610 THIMBLE SHOALS BLVD STE 404",
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"EnumerationDate": "01/30/2018",
"LastUpdateDate": "01/30/2018",
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "JOHNSON",
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"TaxonomyName": "Adult Mental Health Clinic/Center",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}