{
"Npi": {
"NPI": "1508553454",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HEAVENLY HAND SERVICES, 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": "16165 HIGHWAY 51",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "HAZLEHURST",
"MailingAddressStateName": "MS",
"MailingAddressPostalCode": "39083-2002",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "601-894-1120",
"MailingAddressFaxNumber": "844-270-3071",
"FirstLinePracticeLocationAddress": "14062 HIGHWAY 16 W",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DE KALB",
"PracticeLocationAddressStateName": "MS",
"PracticeLocationAddressPostalCode": "39328-7922",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "601-894-1120",
"PracticeLocationAddressFaxNumber": "844-270-3071",
"EnumerationDate": "04/20/2023",
"LastUpdateDate": "10/18/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "NEWTON",
"AuthorizedOfficialFirstName": "CAROL",
"AuthorizedOfficialMiddleName": "P",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "ED. S.",
"AuthorizedOfficialTelephoneNumber": "601-894-1120",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}