{
"Npi": {
"NPI": "1912493750",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.",
"ParentOrgTIN": null,
"OrgName": "PRIOR LEVEL HOME CARE PHYSICAL THERAPY INC.",
"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": "1200 CALIFORNIA ST STE 112",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "REDLANDS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92374-2946",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-312-7099",
"MailingAddressFaxNumber": "909-312-7809",
"FirstLinePracticeLocationAddress": "1200 CALIFORNIA ST STE 112",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "REDLANDS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92374-2946",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-312-7099",
"PracticeLocationAddressFaxNumber": "909-312-7809",
"EnumerationDate": "07/05/2018",
"LastUpdateDate": "07/05/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MCCLINTOCK",
"AuthorizedOfficialFirstName": "ALISON",
"AuthorizedOfficialMiddleName": "RAE",
"AuthorizedOfficialTitle": "CEO/OWNER/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PT",
"AuthorizedOfficialTelephoneNumber": "805-215-2547",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}