{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "KIAWAH, LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2 COLONIAL CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLAINSBORO",
"MailingAddressStateName": "NJ",
"MailingAddressPostalCode": "08536-3113",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "732-236-5968",
"MailingAddressFaxNumber": "609-799-8070",
"FirstLinePracticeLocationAddress": "2200 N FEDERAL HWY",
"SecondLinePracticeLocationAddress": "SUITE 212",
"PracticeLocationAddressCityName": "BOCA RATON",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33431-7766",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-218-4391",
"PracticeLocationAddressFaxNumber": "561-298-4527",
"EnumerationDate": "09/10/2013",
"LastUpdateDate": "09/10/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANDALA",
"AuthorizedOfficialFirstName": "JOSEPH",
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"AuthorizedOfficialTitle": "PRESIDENT",
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"AuthorizedOfficialCredential": "C.S.A",
"AuthorizedOfficialTelephoneNumber": "732-236-5968",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}