{
"Npi": {
"NPI": "1467643320",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "VILLAGE OF DETOUR",
"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": "260 S SUPERIOR STREET",
"SecondLineMailingAddress": "PO BOX 397",
"MailingAddressCityName": "DETOUR",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "49725",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "906-297-5471",
"MailingAddressFaxNumber": "906-297-2107",
"FirstLinePracticeLocationAddress": "206 S ONTARIO STREET",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DETOUR",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "49725",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "906-297-5471",
"PracticeLocationAddressFaxNumber": "906-297-2107",
"EnumerationDate": "08/06/2007",
"LastUpdateDate": "08/06/2007",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FISHER",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "CLERK",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "906-297-5471",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "341600000X",
"TaxonomyName": "Ambulance",
"LicenseNumber": "17 1002",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}