{"npi":"1265007207","type":"NPI-2","status":"active","name":{"display":"Ebenezer Wellness Center INC","other":[],"organization_name":"EBENEZER WELLNESS CENTER INC","authorised_official":"Indira Jimenez"},"specialty":{"primary_taxonomy":"251S00000X","primary_taxonomy_description":"Community/Behavioral Health Agency","slug":"community-behavioral-health-agency","schema_org_specialty":null,"all":[{"code":"2084P0800X","description":"Psychiatry","primary":false,"state":null,"license":null},{"code":"251S00000X","description":"Community/Behavioral Health Agency","primary":true,"state":null,"license":null}]},"addresses":[{"purpose":"LOCATION","street_1":"1200 NW 78TH AVE STE 210","city":"DORAL","state":"FL","postal_code":"331261817","country_code":"US","phone":"7862853438"},{"purpose":"MAILING","street_1":"1200 NW 78TH AVE STE 210","city":"DORAL","state":"FL","postal_code":"331261817","country_code":"US"}],"license":null,"identifiers":[],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20211101002371","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"FL","pac_id":"2668860248"}]},"enumeration_date":"2021-05-21","last_updated":"2023-03-20","_meta":{"source":"NPPES","snapshot_date":"2023-03-20","doc_url":"https://findmynpi.com/api"}}