{
"Npi": {
"NPI": "1134250210",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOSPICE OF LENAWEE, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1903 WOLF CREEK HWY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ADRIAN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49221-8460",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "517-263-2323",
"MailingAddressFaxNumber": "517-263-1425",
"FirstLinePracticeLocationAddress": "1903 WOLF CREEK HWY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ADRIAN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49221-8460",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "517-263-2323",
"PracticeLocationAddressFaxNumber": "517-263-1425",
"EnumerationDate": "03/08/2007",
"LastUpdateDate": "08/12/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HAVENS",
"AuthorizedOfficialFirstName": "TRAVIS",
"AuthorizedOfficialMiddleName": "J",
"AuthorizedOfficialTitle": "PRESIDENT & CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BS, CDP",
"AuthorizedOfficialTelephoneNumber": "517-263-2323",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "463510",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}