{
"Npi": {
"NPI": "1902355431",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIVINGWELL DAY CARE CENTER LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "13781 NORTHERN BLVD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLUSHING",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11354-4320",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "929-362-2477",
"MailingAddressFaxNumber": "929-362-2451",
"FirstLinePracticeLocationAddress": "13781 NORTHERN BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FLUSHING",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "11354-4320",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "929-362-2477",
"PracticeLocationAddressFaxNumber": "929-362-2451",
"EnumerationDate": "09/26/2016",
"LastUpdateDate": "09/26/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SHANG",
"AuthorizedOfficialFirstName": "JIEMIN",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "347-395-7768",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}