{
"Npi": {
"NPI": "1972417681",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMMUNITY VOCATIONAL SERVICES",
"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": "235 VINE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HONESDALE",
"MailingAddressStateName": "PA",
"MailingAddressPostalCode": "18431-1636",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "570-220-6594",
"MailingAddressFaxNumber": "570-796-1007",
"FirstLinePracticeLocationAddress": "235 VINE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HONESDALE",
"PracticeLocationAddressStateName": "PA",
"PracticeLocationAddressPostalCode": "18431-1636",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "570-220-6594",
"PracticeLocationAddressFaxNumber": "579-796-1001",
"EnumerationDate": "09/30/2026",
"LastUpdateDate": "09/30/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "EMMET",
"AuthorizedOfficialFirstName": "KIM",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "570-220-6594",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251C00000X",
"TaxonomyName": "Developmentally Disabled Services Day Training Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "NULL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}