{
"Npi": {
"NPI": "1447774674",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MICHIGAN HOME REHABILITATION L.L.C.",
"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": "501 BALDWIN ST STE 203",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "JENISON",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49428-6904",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "800-880-7715",
"MailingAddressFaxNumber": "888-830-2614",
"FirstLinePracticeLocationAddress": "501 BALDWIN ST STE 203",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "JENISON",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49428-6904",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "800-880-9715",
"PracticeLocationAddressFaxNumber": "888-830-2614",
"EnumerationDate": "07/31/2017",
"LastUpdateDate": "12/22/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DOSS",
"AuthorizedOfficialFirstName": "ROBERT",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "616-827-7715",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}