{
"Npi": {
"NPI": "1982856811",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NEWPORT BEACH SENIOR CARE, 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": "3151 AIRWAY AVE",
"SecondLineMailingAddress": "SUITE K108",
"MailingAddressCityName": "COSTA MESA",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92626-4607",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-432-7700",
"MailingAddressFaxNumber": "714-432-7707",
"FirstLinePracticeLocationAddress": "3151 AIRWAY AVE",
"SecondLinePracticeLocationAddress": "SUITE K108",
"PracticeLocationAddressCityName": "COSTA MESA",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92626-4607",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-432-7700",
"PracticeLocationAddressFaxNumber": "714-432-7707",
"EnumerationDate": "10/22/2008",
"LastUpdateDate": "10/22/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "ELYANN",
"AuthorizedOfficialMiddleName": "GAIL",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CSA",
"AuthorizedOfficialTelephoneNumber": "714-432-7700",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}