{
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"FirstLineMailingAddress": "301 CRAIG ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MOUNT HOLLY",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28120-1265",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-827-1573",
"MailingAddressFaxNumber": "704-827-5705",
"FirstLinePracticeLocationAddress": "301 CRAIG ST",
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"PracticeLocationAddressCityName": "MOUNT HOLLY",
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"PracticeLocationAddressFaxNumber": "704-827-5705",
"EnumerationDate": "02/06/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
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"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LESTER",
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"Taxonomies": {
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"TaxonomyName": "Assisted Living Facility",
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}