{
  "npi": "1447967658",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "SHADRACK",
    "authorized_official_last_name": "BAMPEBUYE",
    "authorized_official_middle_name": "JORAM",
    "authorized_official_name_prefix": "Mr.",
    "authorized_official_telephone_number": "2027632290",
    "authorized_official_title_or_position": "CEO",
    "certification_date": "2022-10-28",
    "enumeration_date": "2022-10-28",
    "last_updated": "2022-10-28",
    "organization_name": "ACTIVE HEALTH SERVICES, INC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "5722 LITTLE SPRING WAY",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FREDERICK",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "217046704",
      "state": "MD",
      "telephone_number": "202-763-2290"
    },
    {
      "address_1": "2915 RHODE ISLAND AVE NE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "WASHINGTON",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "200182943",
      "state": "DC",
      "telephone_number": "202-763-2290"
    }
  ],
  "taxonomies": [
    {
      "code": "101YM0800X",
      "desc": "Counselor, Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "172V00000X",
      "desc": "Community Health Worker",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": "193400000X - Multiple Single Specialty Group"
    },
    {
      "code": "251E00000X",
      "desc": "Home Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "320900000X",
      "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0850X",
      "desc": "Clinic/Center, Adult Mental Health",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QR0405X",
      "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "324500000X",
      "desc": "Substance Abuse Rehabilitation Facility",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "3245S0500X",
      "desc": "Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "385HR2060X",
      "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
      "license": null,
      "primary": false,
      "state": null,
      "taxonomy_group": ""
    },
    {
      "code": "261QM0801X",
      "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
      "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 Outpatient Medical Clinic / Urgent Care & Ambulatory Center",
    "certifying_board": "Accreditation Association for Ambulatory Health Care (AAAHC) / CMS",
    "cms_medicare_crosswalk": [
      {
        "medicare_code": "B4[14]",
        "medicare_type": "Community Mental Health Center"
      }
    ]
  }
}