{
  "npi": "1477358885",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "AYUB",
    "authorized_official_last_name": "OMER",
    "authorized_official_middle_name": "ABDIRAHMAN",
    "authorized_official_telephone_number": "7633218438",
    "authorized_official_title_or_position": "Manager",
    "certification_date": "2025-02-18",
    "enumeration_date": "2025-02-18",
    "last_updated": "2025-02-18",
    "organization_name": "ABLE MINDS SUPPORT SERVICES LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "11032 ZEST ST NE UNIT G",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "BLAINE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "554497489",
      "state": "MN"
    },
    {
      "address_1": "11032 ZEST ST NE UNIT G",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "BLAINE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "554497489",
      "state": "MN",
      "telephone_number": "612-559-6045"
    }
  ],
  "taxonomies": [
    {
      "code": "261QM0850X",
      "desc": "Clinic/Center, Adult Mental Health",
      "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": []
  }
}