{
"Npi": {
"NPI": "1336276583",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEIKKILA ASSISTED LIVING, 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": "12225 W SAVANNA RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FLOODWOOD",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55736-8229",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "218-476-2929",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2304 MCKINNEY LAKE RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GRAND RAPIDS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55744-4323",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "218-326-2226",
"PracticeLocationAddressFaxNumber": "218-327-3312",
"EnumerationDate": "02/27/2007",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HEIKKILA",
"AuthorizedOfficialFirstName": "CHERYL",
"AuthorizedOfficialMiddleName": "JEAN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "218-476-2929",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "334017",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}