{
"Npi": {
"NPI": "1144719436",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "LAUREL CARE INC.",
"ParentOrgTIN": null,
"OrgName": "LAUREL CARE INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "4001 E 29TH ST STE 185",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRYAN",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77802-4211",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "979-314-9771",
"MailingAddressFaxNumber": "979-314-9762",
"FirstLinePracticeLocationAddress": "4001 E 29TH ST STE 185",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRYAN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77802-4211",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "979-314-9771",
"PracticeLocationAddressFaxNumber": "979-314-9762",
"EnumerationDate": "05/02/2018",
"LastUpdateDate": "03/25/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "GRIGGS",
"AuthorizedOfficialFirstName": "RAY",
"AuthorizedOfficialMiddleName": "HERING",
"AuthorizedOfficialTitle": "CO-OWNER, DIRECTOR OF OPERATIONS",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "979-314-9771",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}