{
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"FirstLineMailingAddress": "PO BOX 7071",
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"MailingAddressStateName": "GA",
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"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "5 VINEYARD HAVEN DR",
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"EnumerationDate": "10/13/2011",
"LastUpdateDate": "10/13/2011",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GREEN",
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"AuthorizedOfficialTelephoneNumber": "912-247-8424",
"Taxonomies": {
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"TaxonomyName": "Assisted Living Facility",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}