{
"Npi": {
"NPI": "1992126429",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ASSET CLINIC",
"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": "332 MINNESOTA ST",
"SecondLineMailingAddress": "SUITE W1260",
"MailingAddressCityName": "SAINT PAUL",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55101-1314",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-341-7688",
"MailingAddressFaxNumber": "866-307-8760",
"FirstLinePracticeLocationAddress": "332 MINNESOTA ST",
"SecondLinePracticeLocationAddress": "SUITE W1260",
"PracticeLocationAddressCityName": "SAINT PAUL",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55101-1314",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "651-341-7688",
"PracticeLocationAddressFaxNumber": "866-307-8760",
"EnumerationDate": "12/31/2013",
"LastUpdateDate": "12/31/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WILLENBRING",
"AuthorizedOfficialFirstName": "MARK",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "651-348-7611",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QM0850X",
"TaxonomyName": "Adult Mental Health Clinic/Center",
"LicenseNumber": "1861",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}