{
"Npi": {
"NPI": "1184719734",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SEQUELCARE OF MAINE, 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": "500 ROUTE 1 STE 102",
"SecondLineMailingAddress": "PO BOX 1397",
"MailingAddressCityName": "YARMOUTH",
"MailingAddressStateName": "ME",
"MailingAddressPostalCode": "04096-6816",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "207-847-2273",
"MailingAddressFaxNumber": "207-847-2017",
"FirstLinePracticeLocationAddress": "500 ROUTE 1",
"SecondLinePracticeLocationAddress": "SUITE 102",
"PracticeLocationAddressCityName": "YARMOUTH",
"PracticeLocationAddressStateName": "ME",
"PracticeLocationAddressPostalCode": "04096",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "207-847-2273",
"PracticeLocationAddressFaxNumber": "207-847-2017",
"EnumerationDate": "10/03/2006",
"LastUpdateDate": "08/03/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HYLEN",
"AuthorizedOfficialFirstName": "MICHELE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "888-880-6193",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "02730",
"LicenseNumberStateCode": "ME",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}