{
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"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CHARTER HOME HEALTH OF THE DESERT LLC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "72855 FRED WARING DR",
"SecondLineMailingAddress": "SUITE A4",
"MailingAddressCityName": "PALM DESERT",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92260-9368",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "909-825-2969",
"MailingAddressFaxNumber": "909-825-8751",
"FirstLinePracticeLocationAddress": "72855 FRED WARING DR",
"SecondLinePracticeLocationAddress": "SUITE A4",
"PracticeLocationAddressCityName": "PALM DESERT",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "92260-9368",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "909-825-2969",
"PracticeLocationAddressFaxNumber": "909-825-8751",
"EnumerationDate": "10/18/2012",
"LastUpdateDate": "10/18/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FRANK",
"AuthorizedOfficialFirstName": "FRED",
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"AuthorizedOfficialTitle": "VICE PRESIDENT",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "951-316-4539",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}