{
"Npi": {
"NPI": "1235497009",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHRISTIAN HAVEN HOME",
"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": "704 PENNOYER AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GRAND HAVEN",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49417-1851",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "616-842-0170",
"MailingAddressFaxNumber": "616-842-4886",
"FirstLinePracticeLocationAddress": "704 PENNOYER AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND HAVEN",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49417-1851",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "616-842-0170",
"PracticeLocationAddressFaxNumber": "616-842-4886",
"EnumerationDate": "04/30/2012",
"LastUpdateDate": "04/30/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIXON",
"AuthorizedOfficialFirstName": "LEEANNE",
"AuthorizedOfficialMiddleName": "N",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "616-842-0170",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "AH700236766",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}