{
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"IsOrgSubpart": "N",
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"LastName": null,
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"NamePrefix": null,
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"Credential": null,
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"FirstLineMailingAddress": "4826 E FILLMORE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FRESNO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "93727-3701",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "559-284-6183",
"MailingAddressFaxNumber": "559-452-1536",
"FirstLinePracticeLocationAddress": "4826 E FILLMORE AVE",
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"PracticeLocationAddressCityName": "FRESNO",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "559-284-6183",
"PracticeLocationAddressFaxNumber": "559-452-1536",
"EnumerationDate": "10/05/2011",
"LastUpdateDate": "02/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MILLY",
"AuthorizedOfficialFirstName": "CARMEN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "559-284-6183",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "3104A0625X",
"TaxonomyName": "Assisted Living Facility (Mental Illness)",
"LicenseNumber": "107202478",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}