{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "MANSFIELD MEMORIAL HOMES, INC",
"LastName": null,
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"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "50 BLYMYER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44903-2343",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-774-5120",
"MailingAddressFaxNumber": "419-524-7537",
"FirstLinePracticeLocationAddress": "50 BLYMYER AVE",
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"PracticeLocationAddressCityName": "MANSFIELD",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "419-774-5120",
"PracticeLocationAddressFaxNumber": "419-524-7537",
"EnumerationDate": "07/21/2006",
"LastUpdateDate": "04/24/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LOUGHMAN",
"AuthorizedOfficialFirstName": "RAYMOND",
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"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "419-774-5120",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "064501",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}