{
"Npi": {
"NPI": "1609582220",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "MANA O NANI",
"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": "999 E BASELINE RD APT 2208",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TEMPE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85283-1351",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "833-361-0040",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "64 E BROADWAY RD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TEMPE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85282-1353",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "833-361-0040",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "01/26/2023",
"LastUpdateDate": "01/26/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "URIBE",
"AuthorizedOfficialFirstName": "DIANA",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "CASE MANAGER/",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "833-361-0040",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "171400000X",
"TaxonomyName": "Health & Wellness Coach",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "172A00000X",
"TaxonomyName": "Driver",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "174200000X",
"TaxonomyName": "Meals Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "177F00000X",
"TaxonomyName": "Lodging Provider",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251B00000X",
"TaxonomyName": "Case Management Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "282J00000X",
"TaxonomyName": "Religious Nonmedical Health Care Institution",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "347C00000X",
"TaxonomyName": "Private Vehicle",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "171M00000X",
"TaxonomyName": "Case Manager/Care Coordinator",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": [
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
},
{
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
]
}
}
}