{
"Npi": {
"NPI": "1144479924",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "REVIVAL HOME HEALTH CARE SERVICES, INC",
"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": "8717 SMOKEY CANYON WAY",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "PLANO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "75024-7369",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "469-633-9551",
"MailingAddressFaxNumber": "469-633-9555",
"FirstLinePracticeLocationAddress": "8717 SMOKEY CANYON WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "PLANO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "75024-7369",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "469-633-9551",
"PracticeLocationAddressFaxNumber": "469-633-9555",
"EnumerationDate": "09/16/2008",
"LastUpdateDate": "09/16/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "UDEZE",
"AuthorizedOfficialFirstName": "CHRISTIANA",
"AuthorizedOfficialMiddleName": "NGOZI",
"AuthorizedOfficialTitle": "DIRECTOR OF NURSES/ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "469-633-9557",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "011982",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}