{
"Npi": {
"NPI": "1003496076",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EMKAYHO HOMES 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": "5200 COOL RIVER CT",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MANSFIELD",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "76063-6831",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "817-531-7551",
"MailingAddressFaxNumber": "817-642-9167",
"FirstLinePracticeLocationAddress": "5200 COOL RIVER CT",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MANSFIELD",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "76063-6831",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "401-365-0464",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/13/2021",
"LastUpdateDate": "02/22/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ABIMBOLA",
"AuthorizedOfficialFirstName": "OLABAMIJI",
"AuthorizedOfficialMiddleName": "KAZEEM",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "DR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "DSCPAS/PA-C",
"AuthorizedOfficialTelephoneNumber": "817-531-7551",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "103TA0700X",
"TaxonomyName": "Adult Development & Aging Psychologist",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "261QC1500X",
"TaxonomyName": "Community Health Clinic/Center",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "320600000X",
"TaxonomyName": "Intellectual and/or Developmental Disabilities Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "320700000X",
"TaxonomyName": "Physical Disabilities Residential Treatment Facility",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}