{
"Npi": {
"NPI": "1972810398",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NORTHEAST OHIO APPLIED HEALTH (NOAH)",
"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": "8536 CROW DR",
"SecondLineMailingAddress": "SUITES 30 & 32",
"MailingAddressCityName": "MACEDONIA",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "44056-1900",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "330-467-0085",
"MailingAddressFaxNumber": "330-467-0094",
"FirstLinePracticeLocationAddress": "6834 W SHERRI DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MACEDONIA",
"PracticeLocationAddressStateName": "OH",
"PracticeLocationAddressPostalCode": "44056-2440",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "330-554-8598",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "09/07/2010",
"LastUpdateDate": "09/07/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MASON",
"AuthorizedOfficialFirstName": "DARRYL",
"AuthorizedOfficialMiddleName": "MARC",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR / CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LSW; LCDCIII",
"AuthorizedOfficialTelephoneNumber": "330-467-0085",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": "201023700945",
"LicenseNumberStateCode": "OH",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}