{
  "npi": "1275739492",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_credential": "MLSAC",
    "authorized_official_first_name": "CHRISTINE",
    "authorized_official_last_name": "EDGCOMBE",
    "authorized_official_middle_name": "LAURA",
    "authorized_official_name_prefix": "Ms.",
    "authorized_official_name_suffix": "--",
    "authorized_official_telephone_number": "9098866737",
    "authorized_official_title_or_position": "President CEO",
    "enumeration_date": "2007-06-25",
    "last_updated": "2008-12-10",
    "organization_name": "FAMILY SERVICE AGENCY OF SAN BERNARDINO",
    "organizational_subpart": "YES",
    "parent_organization_legal_business_name": "FAMILY SERVICE AGENCY OF SAN BERNARDINO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "1669 N E ST",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "SAN BERNARDINO",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "924054405",
      "state": "CA",
      "telephone_number": "909-886-6737"
    },
    {
      "address_1": "23406 CREST FOREST DRIVE",
      "address_purpose": "LOCATION",
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      "city": "CRESTLINE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "92325",
      "state": "CA",
      "telephone_number": "909-338-4689"
    }
  ],
  "taxonomies": [
    {
      "code": "251V00000X",
      "desc": "Voluntary or Charitable",
      "license": "0244138",
      "primary": true,
      "state": "CA",
      "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 Agencies — Voluntary or Charitable",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "61",
        "medicare_type": "Voluntary Health or Charitable Agency[1]"
      }
    ]
  }
}