{
"Npi": {
"NPI": "1154877918",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "BOISE HOUSE CALLS, LLC",
"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": "303 ELK CREEK ROAD",
"SecondLineMailingAddress": "PO BOX 88",
"MailingAddressCityName": "IDAHO CITY",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83631",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-484-6703",
"MailingAddressFaxNumber": "208-392-4128",
"FirstLinePracticeLocationAddress": "303 ELK CREEK ROAD",
"SecondLinePracticeLocationAddress": "SUITE BOX 88",
"PracticeLocationAddressCityName": "IDAHO CITY",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83631",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-848-6703",
"PracticeLocationAddressFaxNumber": "208-392-4128",
"EnumerationDate": "08/31/2016",
"LastUpdateDate": "08/31/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MARICLE-KUWAHARA",
"AuthorizedOfficialFirstName": "LYNDA",
"AuthorizedOfficialMiddleName": "JOANNE",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "APRN-C",
"AuthorizedOfficialTelephoneNumber": "208-484-6703",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QP2300X",
"TaxonomyName": "Primary Care Clinic/Center",
"LicenseNumber": "NP 289",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}