{
"Npi": {
"NPI": "1922355593",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MAXIN HEALTH CARE SERVICES 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": "13508 ARCTURUS AVE. GARDENA CA 90249",
"SecondLineMailingAddress": "3756 SANTA ROSALIA DRIVE SUITE 326A",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90008",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "323-290-1360",
"MailingAddressFaxNumber": "323-290-9721",
"FirstLinePracticeLocationAddress": "13508 ARCTURUS AVE. GARDENA CA 90249",
"SecondLinePracticeLocationAddress": "3756 SANTA ROSALIA DRIVE SUITE 326A",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90008",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "323-290-1360",
"PracticeLocationAddressFaxNumber": "323-290-9721",
"EnumerationDate": "08/13/2012",
"LastUpdateDate": "08/13/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NJOKU",
"AuthorizedOfficialFirstName": "MARCEL",
"AuthorizedOfficialMiddleName": "CHIDI",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RECOVERY CARE",
"AuthorizedOfficialTelephoneNumber": "323-290-1360",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "252Y00000X",
"TaxonomyName": "Early Intervention Provider Agency",
"LicenseNumber": "190591AN",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}