{
"Npi": {
"NPI": "1730136490",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TANABELL HEALTH SERVICES, INC.",
"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": "1009 W QUINN RD",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "POCATELLO",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83202-2425",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-221-0481",
"MailingAddressFaxNumber": "775-307-4049",
"FirstLinePracticeLocationAddress": "418 FLOYDE ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MCCALL",
"PracticeLocationAddressStateName": "ID",
"PracticeLocationAddressPostalCode": "83638-4508",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "208-634-2112",
"PracticeLocationAddressFaxNumber": "208-634-3605",
"EnumerationDate": "05/28/2006",
"LastUpdateDate": "01/14/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BELL",
"AuthorizedOfficialFirstName": "TROY",
"AuthorizedOfficialMiddleName": "V",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "208-221-0481",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "16",
"LicenseNumberStateCode": "ID",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}