{"npi":"1114136066","type":"NPI-2","status":"active","name":{"display":"Round Valley Indian Health Center","other":[],"organization_name":"ROUND VALLEY INDIAN HEALTH CENTER","authorised_official":"Otis Brotherton"},"specialty":{"primary_taxonomy":"261QM0801X","primary_taxonomy_description":"Mental Health Clinic/Center (Including Community Mental Health Center)","slug":"mental-health-clinic-center-including-community-mental-health-center","schema_org_specialty":null,"all":[{"code":"261QM0801X","description":"Mental Health Clinic/Center (Including Community Mental Health Center)","primary":true,"state":"CA","license":"230007AN"}]},"addresses":[{"purpose":"LOCATION","street_1":"23000 HENDERSON LANE","city":"COVELO","state":"CA","postal_code":"954280247","country_code":"US","phone":"7079836404","fax":"7079836184"},{"purpose":"MAILING","street_1":"PO BOX 247","city":"COVELO","state":"CA","postal_code":"954280247","country_code":"US","phone":"7079836404","fax":"7079836184"}],"license":{"state":"CA","number":"230007AN"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"THP11697F","state":"CA","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2007-05-21","last_updated":"2024-03-13","_meta":{"source":"NPPES","snapshot_date":"2024-03-13","doc_url":"https://findmynpi.com/api"}}