{
"Npi": {
"NPI": "1578573952",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MARIAN HEALTHCARE 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": "500 E HIGGINS RD",
"SecondLineMailingAddress": "SUITE 210",
"MailingAddressCityName": "ELK GROVE VILLAGE",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60007-1438",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "847-290-1740",
"MailingAddressFaxNumber": "847-290-1760",
"FirstLinePracticeLocationAddress": "500 E HIGGINS RD",
"SecondLinePracticeLocationAddress": "SUITE 210",
"PracticeLocationAddressCityName": "ELK GROVE VILLAGE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60007-1438",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "847-290-1740",
"PracticeLocationAddressFaxNumber": "847-290-1760",
"EnumerationDate": "08/09/2006",
"LastUpdateDate": "05/11/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SERRANO",
"AuthorizedOfficialFirstName": "SALVADOR",
"AuthorizedOfficialMiddleName": "CAOILI",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.D.",
"AuthorizedOfficialTelephoneNumber": "847-290-1740",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1747748",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}