{
"Npi": {
"NPI": "1629520358",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "BHUTANESE HIME HEALTH CARE SERVICES",
"ParentOrgTIN": null,
"OrgName": "BHUTANESE HOME HEALTH CARE SERVICES",
"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": "1901 WAGENER PL",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ROSEVILLE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55113-6962",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "651-493-7514",
"MailingAddressFaxNumber": "651-493-7539",
"FirstLinePracticeLocationAddress": "1901 WAGENER PL",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ROSEVILLE",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55113-6962",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "612-636-2983",
"PracticeLocationAddressFaxNumber": "651-493-7539",
"EnumerationDate": "10/28/2016",
"LastUpdateDate": "10/15/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADHIKARI",
"AuthorizedOfficialFirstName": "BHIM",
"AuthorizedOfficialMiddleName": "RAJ",
"AuthorizedOfficialTitle": "OWNER/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "612-636-2983",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "98792",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}