{
"Npi": {
"NPI": "1154710747",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WEST BRIGHTON HOME CARE SERVICES AGENCY , 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": "797 BRIGHTON AVENUE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "STATEN ISLAND",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "10301",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "718-720-9600",
"MailingAddressFaxNumber": "718-816-5356",
"FirstLinePracticeLocationAddress": "797 BRIGHTON AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "STATEN ISLAND",
"PracticeLocationAddressStateName": "NY",
"PracticeLocationAddressPostalCode": "10301-2736",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "718-720-9600",
"PracticeLocationAddressFaxNumber": "718-816-5356",
"EnumerationDate": "01/20/2015",
"LastUpdateDate": "01/20/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LUSTIG",
"AuthorizedOfficialFirstName": "AVI",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "718-720-9600",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "9980L001",
"LicenseNumberStateCode": "NY",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}