{
"Npi": {
"NPI": "1003244500",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HERITAGE HOME HEALTH CARE 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": "1940 DUKE ST",
"SecondLineMailingAddress": "SUITE 200",
"MailingAddressCityName": "ALEXANDRIA",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "22314-3451",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "571-294-1410",
"MailingAddressFaxNumber": "703-773-6983",
"FirstLinePracticeLocationAddress": "1940 DUKE ST",
"SecondLinePracticeLocationAddress": "SUITE 200",
"PracticeLocationAddressCityName": "ALEXANDRIA",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "22314-3451",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "571-294-1410",
"PracticeLocationAddressFaxNumber": "703-773-6983",
"EnumerationDate": "10/17/2013",
"LastUpdateDate": "10/17/2013",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ERENNA",
"AuthorizedOfficialFirstName": "LENSA",
"AuthorizedOfficialMiddleName": "BEFEKADU",
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CSCM, LPN",
"AuthorizedOfficialTelephoneNumber": "703-409-2990",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "HCO-141019",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}