{"npi":"1104593789","type":"NPI-2","status":"active","name":{"display":"Eden's Vantage LLC","other":[],"organization_name":"EDEN'S VANTAGE LLC","authorised_official":"Emmanuel Okon"},"specialty":{"primary_taxonomy":"363LP0808X","primary_taxonomy_description":"Psychiatric/Mental Health Nurse Practitioner","slug":"psychiatric-mental-health-nurse-practitioner","schema_org_specialty":null,"all":[{"code":"363LP0808X","description":"Psychiatric/Mental Health Nurse Practitioner","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"2553 PETTUS DR","city":"FORNEY","state":"TX","postal_code":"751264172","country_code":"US","phone":"4695695148"},{"purpose":"MAILING","street_1":"2553 PETTUS DR","city":"FORNEY","state":"TX","postal_code":"751264172","country_code":"US","phone":"4695695148"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20220908003385","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"TX","pac_id":"2466836531"}]},"enumeration_date":"2021-08-23","last_updated":"2022-09-08","_meta":{"source":"NPPES","snapshot_date":"2022-09-08","doc_url":"https://findmynpi.com/api"}}