{
"Npi": {
"NPI": "1902055767",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "YES",
"ParentOrgTIN": null,
"OrgName": "WORD OF DELIVERANCE ADULT DAY CARE",
"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": "503 DAVIS AV",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CLEVELAND",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "38732",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "662-402-1970",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "509 DAVIS AVENUE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CLEVELAND",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "38732",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "662-402-1970",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/16/2008",
"LastUpdateDate": "09/16/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BROWN-WILLIAMS",
"AuthorizedOfficialFirstName": "ANNIE",
"AuthorizedOfficialMiddleName": "PEARL",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "662-402-1970",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "4000",
"LicenseNumberStateCode": "MS",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}