{
"Npi": {
"NPI": "1427401728",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "INTERNATIONAL QUALITY HOMECARE OF WISCONSIN LLC",
"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": "3261 19TH ST NW",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROCHESTER",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55901-6786",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "507-252-8117",
"MailingAddressFaxNumber": "507-252-1985",
"FirstLinePracticeLocationAddress": "5600 WOODLAND ST",
"SecondLinePracticeLocationAddress": "STE 3C",
"PracticeLocationAddressCityName": "STEVENS POINT",
"PracticeLocationAddressStateName": "WI",
"PracticeLocationAddressPostalCode": "54482-9317",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "888-544-2282",
"PracticeLocationAddressFaxNumber": "715-544-0077",
"EnumerationDate": "07/21/2016",
"LastUpdateDate": "07/21/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MORDI",
"AuthorizedOfficialFirstName": "ADERONKE",
"AuthorizedOfficialMiddleName": "OLANREWAJU",
"AuthorizedOfficialTitle": "PRESIDENT AND CEO",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "PHD.,MBA, RN",
"AuthorizedOfficialTelephoneNumber": "507-252-8117",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1201",
"LicenseNumberStateCode": "WI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}