{
"Npi": {
"NPI": "1942695242",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GROOM TRANSITIONAL CARE LLC",
"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": "2435 N CENTRAL EXPY",
"SecondLineMailingAddress": "SUITE 890",
"MailingAddressCityName": "RICHARDSON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75080-2753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "214-707-0273",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "401 W CAMPBELL RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHARDSON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75080-3416",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "214-707-0273",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/02/2015",
"LastUpdateDate": "04/02/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GROOM",
"AuthorizedOfficialFirstName": "LORI",
"AuthorizedOfficialMiddleName": "LOVELACE",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MS",
"AuthorizedOfficialTelephoneNumber": "214-707-0273",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}