{
"Npi": {
"NPI": "1568009520",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHI-II WARWICK, 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": "C/O KAPLAN DEVELOPMENT GROUP",
"SecondLineMailingAddress": "100 JERICHO QUADRANGLE, SUITE 142",
"MailingAddressCityName": "JERICHO",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11753",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "516-496-1505",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "55 TOLLGATE HILL FARM RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WARWICK",
"PracticeLocationAddressStateName": "RI",
"PracticeLocationAddressPostalCode": "02886-4495",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-889-5905",
"PracticeLocationAddressFaxNumber": "401-889-5906",
"EnumerationDate": "12/09/2019",
"LastUpdateDate": "12/09/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DIOGUARDI",
"AuthorizedOfficialFirstName": "RAYMOND",
"AuthorizedOfficialMiddleName": "T",
"AuthorizedOfficialTitle": "COO/CFO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "516-496-1505",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "311500000X",
"TaxonomyName": "Alzheimer Center (Dementia Center)",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}