{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LIZZY'S FAMILY HOME CARE & SERVICES, INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
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"FirstLineMailingAddress": "110 N WALNUT CIR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GREENSBORO",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "27409-3105",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "336-509-7693",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2206 EMERYWOOD RD",
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"PracticeLocationAddressCityName": "GREENSBORO",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "27403-3765",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "336-509-7693",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/07/2010",
"LastUpdateDate": "12/07/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "IKEGWU",
"AuthorizedOfficialFirstName": "MGBECHI",
"AuthorizedOfficialMiddleName": "ELIZABETH",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LPN",
"AuthorizedOfficialTelephoneNumber": "336-509-7693",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "311ZA0620X",
"TaxonomyName": "Adult Care Home Facility",
"LicenseNumber": "MHL-041-910",
"LicenseNumberStateCode": "NC",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}