{"npi":"1407925985","type":"NPI-2","status":"active","name":{"display":"Lakeshore Clinic Ltd","other":[],"organization_name":"LAKESHORE CLINIC LTD","authorised_official":"Patricia Briceno"},"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":"WI","license":"1497"}]},"addresses":[{"purpose":"LOCATION","street_1":"3970 N OAKLAND AVE","city":"MILWAUKEE","state":"WI","postal_code":"53211","country_code":"US","street_2":"SUITE 502","phone":"4149629909","fax":"4143328596"},{"purpose":"MAILING","street_1":"3970 N OAKLAND AVE","city":"MILWAUKEE","state":"WI","postal_code":"53211","country_code":"US","street_2":"SUITE 502","phone":"4149629909","fax":"4143328596"}],"license":{"state":"WI","number":"1497"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"42106900","state":"WI","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-11-07","last_updated":"2020-08-22","_meta":{"source":"NPPES","snapshot_date":"2020-08-22","doc_url":"https://findmynpi.com/api"}}