{
"Npi": {
"NPI": "1235600412",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "OASIS AT 56TH, L.P.",
"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": "200 E COURT ST STE 400",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "KANKAKEE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60901-3848",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "815-935-1992",
"MailingAddressFaxNumber": "815-935-8380",
"FirstLinePracticeLocationAddress": "4940 W 56TH ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDIANAPOLIS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46254-1402",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-297-3115",
"PracticeLocationAddressFaxNumber": "317-328-8525",
"EnumerationDate": "12/16/2018",
"LastUpdateDate": "09/18/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ECHOLS",
"AuthorizedOfficialFirstName": "GREG",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CO-PRESIDENT OF MANAGEMENT AGENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "779-216-5849",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}