{
"Npi": {
"NPI": "1659505501",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOSPICE CARE OF NORTHERN UTAH, 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": "2721 N HWY 89",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "PLEASANT VIEW",
"MailingAddressStateName": "UT",
"MailingAddressPostalCode": "84404-6258",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "801-689-3049",
"MailingAddressFaxNumber": "801-689-3045",
"FirstLinePracticeLocationAddress": "2721 N HWY 89",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "PLEASANT VIEW",
"PracticeLocationAddressStateName": "UT",
"PracticeLocationAddressPostalCode": "84404-6258",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "801-689-3049",
"PracticeLocationAddressFaxNumber": "801-689-3045",
"EnumerationDate": "05/06/2009",
"LastUpdateDate": "08/19/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WOOD",
"AuthorizedOfficialFirstName": "EILEEN",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "OWNER/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MSN, CHPN",
"AuthorizedOfficialTelephoneNumber": "801-689-3049",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251G00000X",
"TaxonomyName": "Community Based Hospice Care Agency",
"LicenseNumber": "1015860",
"LicenseNumberStateCode": "UT",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}