{
"Npi": {
"NPI": "1992075048",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MT SILCOX ADULT CARE CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 1721",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "THOMPSON FALLS",
"MailingAddressStateName": "MT",
"MailingAddressPostalCode": "59873-1721",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "406-210-1737",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "210 SOUTH MADISON STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "THOMPSON FALLS",
"PracticeLocationAddressStateName": "MT",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "406-210-1721",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/06/2012",
"LastUpdateDate": "01/06/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HENZE",
"AuthorizedOfficialFirstName": "MARY",
"AuthorizedOfficialMiddleName": "LOU",
"AuthorizedOfficialTitle": "OWNER/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MISS",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "406-210-1737",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "0043361001",
"LicenseNumberStateCode": "MT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}