{
"Npi": {
"NPI": "1144659020",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "NOVA LUNA, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "16-643 KIPIMANA STREET",
"SecondLineMailingAddress": "SUITE 20 NOVA LUNA INC C/O MICROIMAGING",
"MailingAddressCityName": "KEAAU",
"MailingAddressStateName": "HI",
"MailingAddressPostalCode": "96749",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "808-966-7453",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "470 LILIHUA PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WAILUKU",
"PracticeLocationAddressStateName": "HI",
"PracticeLocationAddressPostalCode": "96793-1313",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "808-249-9999",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/01/2013",
"LastUpdateDate": "11/01/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MEYER-UYEHARA",
"AuthorizedOfficialFirstName": "CATHY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "FACHE",
"AuthorizedOfficialTelephoneNumber": "808-386-5849",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "320800000X",
"TaxonomyName": "Mental Illness Community Based Residential Treatment Facility",
"LicenseNumber": "98-STF",
"LicenseNumberStateCode": "HI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}