{
"Npi": {
"NPI": "1346447265",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MED HEALTH HOSPICE CORP",
"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": "154 CARR 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CABO ROJO",
"MailingAddressStateName": "PR",
"MailingAddressPostalCode": "00623-3138",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "787-254-4307",
"MailingAddressFaxNumber": "787-254-4307",
"FirstLinePracticeLocationAddress": "BO GUANAJIBO SECTOR PARABUEYON",
"SecondLinePracticeLocationAddress": "CARR 102 KM 18.6",
"PracticeLocationAddressCityName": "CABO ROJO",
"PracticeLocationAddressStateName": "PR",
"PracticeLocationAddressPostalCode": "00623",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "787-254-4307",
"PracticeLocationAddressFaxNumber": "787-254-4307",
"EnumerationDate": "07/03/2007",
"LastUpdateDate": "03/28/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTALVO",
"AuthorizedOfficialFirstName": "LUIS",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "787-254-4307",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "001367",
"LicenseNumberStateCode": "PR",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}