{
"Npi": {
"NPI": "1891661781",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "ADAPT",
"ParentOrgTIN": null,
"OrgName": "ADAPT",
"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": "621 W MADRONE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROSEBURG",
"MailingAddressStateName": "OR",
"MailingAddressPostalCode": "97470-3090",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "541-492-0134",
"MailingAddressFaxNumber": "541-492-0190",
"FirstLinePracticeLocationAddress": "625 PIONEER ROARD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKINGS",
"PracticeLocationAddressStateName": "OR",
"PracticeLocationAddressPostalCode": "97415-8293",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "541-347-2529",
"PracticeLocationAddressFaxNumber": "541-347-9196",
"EnumerationDate": "10/16/2025",
"LastUpdateDate": "10/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PHILLIPS",
"AuthorizedOfficialFirstName": "DEBBIE",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "DIRECTOR OR REVENUE CYCLE",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "541-492-0134",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QF0400X",
"TaxonomyName": "Federally Qualified Health Center (FQHC)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}