{
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"EIN": null,
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"IsOrgSubpart": "N",
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"NamePrefix": null,
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"Credential": null,
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"FirstLineMailingAddress": "1111 S ORCHARD ST STE 208",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BOISE",
"MailingAddressStateName": "ID",
"MailingAddressPostalCode": "83705-1922",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "208-342-3013",
"MailingAddressFaxNumber": "208-344-3502",
"FirstLinePracticeLocationAddress": "1111 S ORCHARD ST",
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"PracticeLocationAddressTelephoneNumber": "208-342-3013",
"PracticeLocationAddressFaxNumber": "208-344-3502",
"EnumerationDate": "07/24/2008",
"LastUpdateDate": "07/24/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KRAWL",
"AuthorizedOfficialFirstName": "TRAVIS",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "208-342-3013",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}