{
"Npi": {
"NPI": "1346398351",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ADVANCED HEALTHCARE SERVICES, LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "3900 PINTAIL DRIVE",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "SPRINGFIELD",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "62711-7380",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "217-726-6956",
"MailingAddressFaxNumber": "217-726-7082",
"FirstLinePracticeLocationAddress": "3900 PINTAIL DRIVE",
"SecondLinePracticeLocationAddress": "SUITE A",
"PracticeLocationAddressCityName": "SPRINGFIELD",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "62711-7380",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "217-726-6956",
"PracticeLocationAddressFaxNumber": "217-726-7082",
"EnumerationDate": "01/08/2007",
"LastUpdateDate": "12/15/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "AGNO",
"AuthorizedOfficialFirstName": "CRISTINA",
"AuthorizedOfficialMiddleName": "CAOILI",
"AuthorizedOfficialTitle": "ADMINISTRATOR/MANAGING MEMBER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.N.",
"AuthorizedOfficialTelephoneNumber": "217-726-6956",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1010686",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}