{
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"FirstLineMailingAddress": "P.O. BOX 4060",
"SecondLineMailingAddress": "ATTN: REGULATORY",
"MailingAddressCityName": "MOORESVILLE",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28117",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "704-664-2876",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "105 E CRANDALL AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HARRISON",
"PracticeLocationAddressStateName": "AR",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "870-280-2926",
"PracticeLocationAddressFaxNumber": "870-204-6557",
"EnumerationDate": "10/28/2021",
"LastUpdateDate": "11/26/2024",
"NPIDeactivationReasonCode": null,
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"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "COMBS",
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"AuthorizedOfficialTelephoneNumber": "704-664-2876",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
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}
}