{
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"NPI": "1861993099",
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"EIN": null,
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"IsOrgSubpart": "N",
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"OrgName": "A SUMMERDALE HOMES @ RIBEIRO LLC",
"LastName": null,
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"NamePrefix": null,
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"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1868 RIBEIRO CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RENO",
"MailingAddressStateName": "NV",
"MailingAddressPostalCode": "89503-4035",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "775-746-1949",
"MailingAddressFaxNumber": "775-746-9244",
"FirstLinePracticeLocationAddress": "1868 RIBEIRO CIR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RENO",
"PracticeLocationAddressStateName": "NV",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "775-746-1949",
"PracticeLocationAddressFaxNumber": "775-746-9244",
"EnumerationDate": "02/22/2018",
"LastUpdateDate": "02/22/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GASATAYA",
"AuthorizedOfficialFirstName": "EUGENE",
"AuthorizedOfficialMiddleName": "ROBLES",
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"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-855-4862",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "2194-AGC-27",
"LicenseNumberStateCode": "NV",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}