{
  "npi": "1083362768",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "TYIESHA",
    "authorized_official_last_name": "BROWN",
    "authorized_official_telephone_number": "8176807912",
    "authorized_official_title_or_position": "Administrator",
    "certification_date": "2022-03-12",
    "enumeration_date": "2022-03-12",
    "last_updated": "2022-03-12",
    "organization_name": "4HEALING HEARTS INC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "PO BOX 8006",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FORT WORTH",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "817-887-2415",
      "postal_code": "761240006",
      "state": "TX",
      "telephone_number": "817-680-7912"
    },
    {
      "address_1": "1613 GREENDALE CT",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "FORT WORTH",
      "country_code": "US",
      "country_name": "United States",
      "fax_number": "817-887-2415",
      "postal_code": "761123410",
      "state": "TX",
      "telephone_number": "817-680-7912"
    }
  ],
  "taxonomies": [
    {
      "code": "251B00000X",
      "desc": "Case Management",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "253J00000X",
      "desc": "Foster Care Agency",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0855X",
      "desc": "Clinic/Center, Adolescent and Children Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "1041C0700X",
      "desc": "Social Worker, Clinical",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193200000X - Multi-Specialty Group"
    },
    {
      "code": "322D00000X",
      "desc": "Residential Treatment Facility, Emotionally Disturbed Children",
      "license": null,
      "primary": true,
      "state": null,
      "taxonomy_group": ""
    }
  ],
  "compliance": {
    "oig_leie_exclusion": {
      "excluded": false,
      "status": "CLEAR",
      "matches": [],
      "totalDbRecords": 84224
    },
    "cms_pecos_eligibility": {
      "note": "Not listed in CMS Order & Referring PECOS file or institutional NPI-2"
    }
  },
  "medicare_utilization": null,
  "enrichment": {
    "plain_english_specialty": "Licensed & Credentialed Residential Treatment Facility, Emotionally Disturbed Children",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}