{
"Npi": {
"NPI": "1528342441",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ELITE HEALTH OF MICHIGAN",
"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": "4820 FOX CRK E",
"SecondLineMailingAddress": "#135",
"MailingAddressCityName": "CLARKSTON",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48346-4946",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "248-802-7743",
"MailingAddressFaxNumber": "248-650-3751",
"FirstLinePracticeLocationAddress": "1424 N ROCHESTER RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROCHESTER HILLS",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48307-1188",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "248-650-6100",
"PracticeLocationAddressFaxNumber": "248-650-3751",
"EnumerationDate": "10/11/2011",
"LastUpdateDate": "02/08/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TOCCO",
"AuthorizedOfficialFirstName": "LIA",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER OF LLC",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "D.C.",
"AuthorizedOfficialTelephoneNumber": "248-802-7743",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "261QH0100X",
"TaxonomyName": "Health Service Clinic/Center",
"LicenseNumber": "2301009839",
"LicenseNumberStateCode": "MI",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}