{
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "CEREBRAL PALSY ADULT HOME, INC.",
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"FirstLineMailingAddress": "1001 NE 3RD AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POMPANO BEACH",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33060-5712",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "965-786-0344",
"MailingAddressFaxNumber": "954-785-6635",
"FirstLinePracticeLocationAddress": "1405 NW 10TH ST",
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"PracticeLocationAddressCityName": "DANIA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "954-786-0344",
"PracticeLocationAddressFaxNumber": "954-785-6635",
"EnumerationDate": "01/15/2008",
"LastUpdateDate": "01/15/2008",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LINVILLE",
"AuthorizedOfficialFirstName": "MARSHA",
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"AuthorizedOfficialTelephoneNumber": "954-786-0344",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "320600000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
"LicenseNumber": "10-1454GH",
"LicenseNumberStateCode": "FL",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}