{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "GOLDEN COAST SENIOR LIVING",
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"NamePrefix": null,
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"Credential": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "28562 OSO PKWY # D-319",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RSM",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92688-5595",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "949-533-4025",
"MailingAddressFaxNumber": "949-288-6255",
"FirstLinePracticeLocationAddress": "28562 OSO PKWY # D-319",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RSM",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "949-533-4025",
"PracticeLocationAddressFaxNumber": "949-288-6255",
"EnumerationDate": "01/19/2015",
"LastUpdateDate": "01/08/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "VILLARREAL",
"AuthorizedOfficialFirstName": "USHA",
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"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "949-533-4025",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "2326667",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}