{
"Npi": {
"NPI": "1609106251",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRANNY'S LOG CABIN CARE CENTER",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "647 N TIFFANY DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PALMER",
"MailingAddressStateName": "AK",
"MailingAddressPostalCode": "99645-8410",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "907-357-8800",
"MailingAddressFaxNumber": "907-357-5813",
"FirstLinePracticeLocationAddress": "3041 N CAMBAY CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "WASILLA",
"PracticeLocationAddressStateName": "AK",
"PracticeLocationAddressPostalCode": "99654-1271",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "907-631-3261",
"PracticeLocationAddressFaxNumber": "907-357-5813",
"EnumerationDate": "01/04/2010",
"LastUpdateDate": "01/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUTTERS",
"AuthorizedOfficialFirstName": "SHERRY",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "907-357-8800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "310400000X",
"TaxonomyName": "Assisted Living Facility",
"LicenseNumber": "100785",
"LicenseNumberStateCode": "AK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}