{
  "npi": "1720794274",
  "enumeration_type": "NPI-2",
  "basic": {
    "authorized_official_first_name": "PATRICK",
    "authorized_official_last_name": "PATTON",
    "authorized_official_telephone_number": "9735460488",
    "authorized_official_title_or_position": "COO",
    "certification_date": "2023-01-27",
    "enumeration_date": "2023-01-27",
    "last_updated": "2023-01-27",
    "organization_name": "BROADWAY GROUP HOME LLC",
    "organizational_subpart": "NO",
    "status": "A"
  },
  "addresses": [
    {
      "address_1": "17-17 BROADWAY",
      "address_purpose": "MAILING",
      "address_type": "DOM",
      "city": "FAIR LAWN",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "074102055",
      "state": "NJ",
      "telephone_number": "201-703-3980"
    },
    {
      "address_1": "20 LOWER MATCHAPONIX AVE",
      "address_purpose": "LOCATION",
      "address_type": "DOM",
      "city": "MONROE",
      "country_code": "US",
      "country_name": "United States",
      "postal_code": "088311424",
      "state": "NJ",
      "telephone_number": "973-546-0488"
    }
  ],
  "taxonomies": [
    {
      "code": "320900000X",
      "desc": "Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
      "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 Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities",
    "certifying_board": "State Medical / Healthcare Licensing Board & National Specialty Board",
    "cms_medicare_crosswalk": []
  }
}