{
"Npi": {
"NPI": "1932639663",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOLISTIC TREATMENT CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "12301 LOCH CARRON CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FORT WASHINGTON",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "20744-7017",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-490-1421",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3050 CRAIN HWY STE 200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WALDORF",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "20601-2822",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "571-490-1421",
"PracticeLocationAddressFaxNumber": "571-490-1421",
"EnumerationDate": "06/15/2017",
"LastUpdateDate": "06/15/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUTLER",
"AuthorizedOfficialFirstName": "RENEE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LCSW-CQ",
"AuthorizedOfficialTelephoneNumber": "571-490-1421",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261Q00000X",
"TaxonomyName": "Clinic/Center",
"LicenseNumber": "20563",
"LicenseNumberStateCode": "MD",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}