{
"Npi": {
"NPI": "1831375062",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CIRCLE OF LIFE TRANSITION CENTER, LLC",
"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": "1 CONGRESS ST",
"SecondLineMailingAddress": "SUITE 207",
"MailingAddressCityName": "HARTFORD",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06114-1067",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-293-1000",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1 CONGRESS ST",
"SecondLinePracticeLocationAddress": "SUITE 207",
"PracticeLocationAddressCityName": "HARTFORD",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06114-1067",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-293-1000",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/17/2008",
"LastUpdateDate": "10/13/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLIAMS",
"AuthorizedOfficialFirstName": "VALARIE",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR/CLINICIAN",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPC",
"AuthorizedOfficialTelephoneNumber": "860-293-1000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}