{"npi":"1548496201","type":"NPI-2","status":"active","name":{"display":"Grand Teton Service Group","other":[],"organization_name":"GRAND TETON SERVICE GROUP","authorised_official":"Lisa Bowman"},"specialty":{"primary_taxonomy":"320600000X","primary_taxonomy_description":"Intellectual and/or Developmental Disabilities Residential Treatment Facility","slug":"intellectual-and-or-developmental-disabilities-residential-treatment-facility","schema_org_specialty":null,"all":[{"code":"320600000X","description":"Intellectual and/or Developmental Disabilities Residential Treatment Facility","primary":true,"state":"ID","license":"RHA-313"}]},"addresses":[{"purpose":"LOCATION","street_1":"329 PARK AVE","city":"IDAHO FALLS","state":"ID","postal_code":"834023610","country_code":"US","phone":"2085287443","fax":"2085287321"},{"purpose":"MAILING","street_1":"PO BOX 50457","city":"IDAHO FALLS","state":"ID","postal_code":"834050457","country_code":"US","phone":"2085287443","fax":"2085287321"}],"license":{"state":"ID","number":"RHA-313"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"0026996","state":"ID","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2009-06-08","last_updated":"2009-06-08","_meta":{"source":"NPPES","snapshot_date":"2009-06-08","doc_url":"https://findmynpi.com/api"}}