{
"Npi": {
"NPI": "1912208133",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "J & J RESIDENTIAL SERVICES INCORPORATED",
"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": "65 TANNER STREET",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SMITHFIELD",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43948",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "740-733-7095",
"MailingAddressFaxNumber": "740-733-8509",
"FirstLinePracticeLocationAddress": "43 GREENE STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SMITHFIELD",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "43948",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "740-733-7095",
"PracticeLocationAddressFaxNumber": "740-733-8509",
"EnumerationDate": "11/04/2010",
"LastUpdateDate": "11/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CLINE",
"AuthorizedOfficialFirstName": "DONALD",
"AuthorizedOfficialMiddleName": "ANDERSON",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "740-733-7095",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "385HR2060X",
"TaxonomyName": "Child Intellectual and/or Developmental Disabilities Respite Care",
"LicenseNumber": "4110054",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}