{
"Npi": {
"NPI": "1215471669",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHS OF NORTHERN MICHIGAN LLC",
"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": "221 E FELSHAW ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GAYLORD",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49735-1603",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "989-448-8323",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "221 E FELSHAW ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GAYLORD",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49735-1603",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "989-448-8323",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "12/05/2016",
"LastUpdateDate": "12/05/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "PARKES",
"AuthorizedOfficialFirstName": "CARLA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "989-448-8323",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "D4128P",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}