{
"Npi": {
"NPI": "1295380020",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UP NORTH HHC SERVICE CORPORATION",
"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": "17443 COUNTY ROAD 561",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PENGILLY",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55775-2051",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "17443 COUNTY ROAD 561",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PENGILLY",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55775-2051",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "763-807-9924",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "08/08/2019",
"LastUpdateDate": "04/22/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUFFMAN",
"AuthorizedOfficialFirstName": "LEIGHA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "RN, OWNER, MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN,BSN,PHN",
"AuthorizedOfficialTelephoneNumber": "763-807-9924",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}