{
"Npi": {
"NPI": "1285679118",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DIVINE HOSPICE INC",
"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": "345 WESTPARK WAY",
"SecondLineMailingAddress": "#101",
"MailingAddressCityName": "EULESS",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76040-3913",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-268-1946",
"MailingAddressFaxNumber": "817-268-0722",
"FirstLinePracticeLocationAddress": "345 WESTPARK WAY",
"SecondLinePracticeLocationAddress": "#101",
"PracticeLocationAddressCityName": "EULESS",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76040-3913",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "817-268-1946",
"PracticeLocationAddressFaxNumber": "817-268-0209",
"EnumerationDate": "06/17/2006",
"LastUpdateDate": "02/13/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRYANT",
"AuthorizedOfficialFirstName": "CONSOLOTA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "817-268-1946",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "008914",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}