{
"Npi": {
"NPI": "1063157667",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GENTLE HANDS HOME HEALTH AGENCY",
"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": "813 W WHITTIER BLVD STE 206",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "MONTEBELLO",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90640-4768",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": null,
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "813 W WHITTIER BLVD STE 206",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MONTEBELLO",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90640-4768",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-300-8047",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/28/2022",
"LastUpdateDate": "09/09/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ADIKYAN",
"AuthorizedOfficialFirstName": "ARMAN MATSAKOVICH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-300-8047",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}