{
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"FirstLineMailingAddress": "405 PARKWAY STE A",
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"MailingAddressCityName": "GREENSBORO",
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"MailingAddressPostalCode": "27401-1693",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-274-5909",
"MailingAddressFaxNumber": "336-274-3622",
"FirstLinePracticeLocationAddress": "5016 W FRIENDLY AVE",
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"EnumerationDate": "01/30/2007",
"LastUpdateDate": "03/11/2019",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
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"AuthorizedOfficialLastName": "LEWIS",
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"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Emotionally Disturbed Childrens' Residential Treatment Facility",
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"PrimaryTaxonomySwitch": "Y"
}
},
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}
}