{
"Npi": {
"NPI": "1790776888",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GREATLAND HOME HEALTH SERVICES, INC.",
"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": "PO BOX 1010",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOLINGBROOK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60440-0141",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "630-548-2126",
"MailingAddressFaxNumber": "630-364-1506",
"FirstLinePracticeLocationAddress": "24W500 MAPLE AVE",
"SecondLinePracticeLocationAddress": "SUITE 205",
"PracticeLocationAddressCityName": "NAPERVILLE",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60540-6055",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "630-548-2126",
"PracticeLocationAddressFaxNumber": "630-364-1506",
"EnumerationDate": "10/29/2005",
"LastUpdateDate": "01/09/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HASSAN",
"AuthorizedOfficialFirstName": "MONSURU",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "630-548-2126",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "IL1010350",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}