{
"Npi": {
"NPI": "1164048963",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEAVEN HEALTH 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": "11303 TEMPLE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "COOPER CITY",
"MailingAddressStateName": "FL",
"MailingAddressPostalCode": "33330-4442",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "561-451-6464",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1781 NW 123RD AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PEMBROKE PINES",
"PracticeLocationAddressStateName": "FL",
"PracticeLocationAddressPostalCode": "33026-4383",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "561-451-6464",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/18/2020",
"LastUpdateDate": "06/18/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIEGUEZ RODRIGUEZ",
"AuthorizedOfficialFirstName": "YANNET",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "561-451-6464",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}