{"npi":"1780730267","type":"NPI-2","status":"active","name":{"display":"Community Child Guidance Clinic, Inc.","other":[],"organization_name":"COMMUNITY CHILD GUIDANCE CLINIC, INC.","authorised_official":"Clifford Johnson"},"specialty":{"primary_taxonomy":"261QM0855X","primary_taxonomy_description":"Adolescent and Children Mental Health Clinic/Center","slug":"adolescent-and-children-mental-health-clinic-center","schema_org_specialty":null,"all":[{"code":"261Q00000X","description":"Clinic/Center","primary":false,"state":"CT","license":"0238"},{"code":"261QM0855X","description":"Adolescent and Children Mental Health Clinic/Center","primary":true,"state":"CT","license":"OPCC-14"}]},"addresses":[{"purpose":"LOCATION","street_1":"317 N MAIN ST","city":"MANCHESTER","state":"CT","postal_code":"060422007","country_code":"US","phone":"8606432101","fax":"8606451470"},{"purpose":"MAILING","street_1":"317 N MAIN ST","city":"MANCHESTER","state":"CT","postal_code":"060422007","country_code":"US","phone":"8606432101","fax":"8606451470"}],"license":{"state":"CT","number":"OPCC-14"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"004039277","state":"CT","issuer":null}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2007-01-26","last_updated":"2013-05-03","_meta":{"source":"NPPES","snapshot_date":"2013-05-03","doc_url":"https://findmynpi.com/api"}}