{
"Npi": {
"NPI": "1235506189",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "PERSONAL SERVICE PROVIDERS",
"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": "720 LEVEE ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HOQUIAM",
"MailingAddressStateName": "WA",
"MailingAddressPostalCode": "98550-2517",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "360-538-1540",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "720 LEVEE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOQUIAM",
"PracticeLocationAddressStateName": "WA",
"PracticeLocationAddressPostalCode": "98550-2517",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "360-538-1540",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/26/2015",
"LastUpdateDate": "08/26/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "STEPHENS",
"AuthorizedOfficialFirstName": "JOEL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSW",
"AuthorizedOfficialTelephoneNumber": "360-538-1540",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "IHS.FS.00000408",
"LicenseNumberStateCode": "WA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}