{
"Npi": {
"NPI": "1952813016",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KINCAID SENIOR LIVING 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": "PO BOX 74452",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SAN CLEMENTE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92673-0149",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-822-8878",
"MailingAddressFaxNumber": "714-827-9637",
"FirstLinePracticeLocationAddress": "641 S BEACH BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ANAHEIM",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92804-3102",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-827-7007",
"PracticeLocationAddressFaxNumber": "714-827-9637",
"EnumerationDate": "10/30/2017",
"LastUpdateDate": "10/30/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KINCAID",
"AuthorizedOfficialFirstName": "KIM",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "714-914-7226",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "306005316",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}