{
"Npi": {
"NPI": "1649719584",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ARIZONA SELECT HOSPICE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "1270 E BROADWAY AVE",
"SecondLineMailingAddress": "STE 101",
"MailingAddressCityName": "TEMPE",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85282",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "1270 E BROADWAY RD",
"SecondLinePracticeLocationAddress": "STE 101",
"PracticeLocationAddressCityName": "TEMPE",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85282-1517",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "480-750-4008",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/13/2017",
"LastUpdateDate": "07/14/2017",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MIKULS",
"AuthorizedOfficialFirstName": "STEPHEN",
"AuthorizedOfficialMiddleName": "M",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "913-544-8800",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "HSPC7956",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}