{
"Npi": {
"NPI": "1285324459",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AAH OF WISCONSIN I, 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": "10 CADILLAC DR STE 400",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRENTWOOD",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "37027-1001",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-637-9163",
"MailingAddressFaxNumber": "615-373-4457",
"FirstLinePracticeLocationAddress": "134 W COLUMBIA ST STE 2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CHIPPEWA FALLS",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54729-2347",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "715-861-8353",
"PracticeLocationAddressFaxNumber": "715-203-0273",
"EnumerationDate": "05/11/2023",
"LastUpdateDate": "05/11/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADKINS",
"AuthorizedOfficialFirstName": "RUSSELL",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "SVP, CHIEF LEGAL OFFICER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "615-309-5668",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}