{
"Npi": {
"NPI": "1447833009",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "IVORY HOSPICE INC",
"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": "2777 PACIFIC AVE. K 2 1/2",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LONG BEACH",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90806",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "562-473-0088",
"MailingAddressFaxNumber": "562-473-0080",
"FirstLinePracticeLocationAddress": "2777 PACIFIC AVE. K 2 1/2",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LONG BEACH",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90806",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "562-473-0088",
"PracticeLocationAddressFaxNumber": "562-473-0080",
"EnumerationDate": "05/03/2021",
"LastUpdateDate": "05/03/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OSEI NYARKO",
"AuthorizedOfficialFirstName": "ADWOA SERWA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "562-473-0088",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251F00000X",
"TaxonomyName": "Home Infusion Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}