{
"Npi": {
"NPI": "1811458573",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEW LIFE FOUNDATION RECOVERY 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": "1541 CHURCH RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BEAR",
"MailingAddressStateName": "DE",
"MailingAddressPostalCode": "19701-1826",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "302-317-2212",
"MailingAddressFaxNumber": "302-365-5648",
"FirstLinePracticeLocationAddress": "11 PARKWAY CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "NEW CASTLE",
"PracticeLocationAddressStateName": "DE",
"PracticeLocationAddressPostalCode": "19720-4077",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "302-562-0639",
"PracticeLocationAddressFaxNumber": "302-365-5648",
"EnumerationDate": "03/26/2019",
"LastUpdateDate": "06/22/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IKONNE",
"AuthorizedOfficialFirstName": "MORGAN",
"AuthorizedOfficialMiddleName": "N.",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "302-317-2212",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "101YA0400X",
"TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}