{
"Npi": {
"NPI": "1043615925",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SHILOH HOME HEALTH INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4301 LARGO ST STE A",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON",
"MailingAddressStateName": "NM",
"MailingAddressPostalCode": "87402-8629",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "505-436-3350",
"MailingAddressFaxNumber": "505-213-1523",
"FirstLinePracticeLocationAddress": "4301 LARGO ST STE A",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "FARMINGTON",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87402-8629",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-436-3350",
"PracticeLocationAddressFaxNumber": "505-213-1523",
"EnumerationDate": "11/04/2014",
"LastUpdateDate": "11/04/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GONZALES",
"AuthorizedOfficialFirstName": "SARA",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OWNER, ADMINISTRATOR, R.N.",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.N.,ADMINISTRATOR,",
"AuthorizedOfficialTelephoneNumber": "505-436-3350",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "314000000X",
"TaxonomyName": "Skilled Nursing Facility",
"LicenseNumber": "R52598",
"LicenseNumberStateCode": "NM",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}