{"npi":"1063459501","type":"NPI-2","status":"active","name":{"display":"1130 Seventeenth Avenue Operations LLC","other":[],"organization_name":"1130 SEVENTEENTH AVENUE OPERATIONS LLC","authorised_official":"Michael Berg"},"specialty":{"primary_taxonomy":"314000000X","primary_taxonomy_description":"Skilled Nursing Facility","slug":"skilled-nursing-facility","schema_org_specialty":null,"all":[{"code":"314000000X","description":"Skilled Nursing Facility","primary":true,"state":"MT","license":"12680"}]},"addresses":[{"purpose":"LOCATION","street_1":"1130 17TH AVE S","city":"GREAT FALLS","state":"MT","postal_code":"594054523","country_code":"US","phone":"4067714500"},{"purpose":"MAILING","street_1":"1130 17TH AVE S","city":"GREAT FALLS","state":"MT","postal_code":"594054523","country_code":"US","phone":"4067714500"}],"license":{"state":"MT","number":"12680"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"3400982","state":"MT","issuer":null},{"type_code":"05","label":"Medicaid","value":"0534548","state":"MT","issuer":null},{"type_code":"05","label":"Medicaid","value":"310301","state":"MT","issuer":null},{"type_code":"05","label":"Medicaid","value":"3400969","state":"MT","issuer":null},{"type_code":"01","label":"Other","value":"41502","state":"MT","issuer":"BC/BS"}],"pecos":{"enrolled_at":null,"enrollments":[]},"enumeration_date":"2006-06-01","last_updated":"2016-05-17","_meta":{"source":"NPPES","snapshot_date":"2016-05-17","doc_url":"https://findmynpi.com/api"}}