{
"Npi": {
"NPI": "1467430199",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ST. LIZ 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": "1910 W SUNSET BLVD.",
"SecondLineMailingAddress": "SUITE 420",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90026-3281",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "213-365-6499",
"MailingAddressFaxNumber": "888-415-5250",
"FirstLinePracticeLocationAddress": "1910 W SUNSET BLVD.",
"SecondLinePracticeLocationAddress": "SUITE 420",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90026-3281",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "213-365-6499",
"PracticeLocationAddressFaxNumber": "888-415-5250",
"EnumerationDate": "01/03/2006",
"LastUpdateDate": "01/05/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "YAO",
"AuthorizedOfficialFirstName": "RICARDO",
"AuthorizedOfficialMiddleName": "MORENO",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CERT. HOSPICE ADM.",
"AuthorizedOfficialTelephoneNumber": "213-365-6499",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "980001331",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}