NPI Code Detail JSON Logo

1104203173 NPI number — OUR HOME HOSPICE LLC

NPI Number: 1104203173
Health Care Provider/Practitioner: OUR HOME HOSPICE LLC

Information about “1104203173” NPI (OUR HOME HOSPICE LLC) exists in 1104203173 in HTML format HTML  |  1104203173 in plain Text format TXT  |  1104203173 in PDF (Portable Document Format) PDF  |  1104203173 in an XML format XML  formats.

NPI Number : 1104203173 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1104203173",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "OUR HOME HOSPICE 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": "2665 VILLA CREEK DR",
    "SecondLineMailingAddress": "SUITE 258",
    "MailingAddressCityName": "DALLAS",
    "MailingAddressStateName": "TX",
    "MailingAddressPostalCode": "75234-7309",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "214-436-3188",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2665 VILLA CREEK DR",
    "SecondLinePracticeLocationAddress": "SUITE 258",
    "PracticeLocationAddressCityName": "DALLAS",
    "PracticeLocationAddressStateName": "TX",
    "PracticeLocationAddressPostalCode": "75234-7309",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "214-436-3188",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/29/2015",
    "LastUpdateDate": "04/29/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "GAINES",
    "AuthorizedOfficialFirstName": "BEN",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "214-436-3188",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "251G00000X",
        "TaxonomyName": "Community Based Hospice Care Agency",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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