{
"Npi": {
"NPI": "1285523647",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADVANCE INTERVENTION SERVICES",
"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": "3610 DODGE ST STE 105",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "OMAHA",
"MailingAddressStateName": "NE",
"MailingAddressPostalCode": "68131-3218",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "402-319-1264",
"MailingAddressFaxNumber": "402-319-1264",
"FirstLinePracticeLocationAddress": "3610 DODGE ST STE 105",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "OMAHA",
"PracticeLocationAddressStateName": "NE",
"PracticeLocationAddressPostalCode": "68131-3218",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "402-319-1264",
"PracticeLocationAddressFaxNumber": "402-319-1264",
"EnumerationDate": "07/01/2025",
"LastUpdateDate": "07/01/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MICHAEL",
"AuthorizedOfficialFirstName": "ANNA",
"AuthorizedOfficialMiddleName": "TUKWAJE",
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN, BSN",
"AuthorizedOfficialTelephoneNumber": "402-319-1264",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}