{
"Npi": {
"NPI": "1154818706",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FIRST DIVINE HOME HEALTHCARE AGENCY 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": "2612 BYFIELD DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CEDAR PARK",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "78613-7614",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "512-870-7395",
"MailingAddressFaxNumber": "512-456-7450",
"FirstLinePracticeLocationAddress": "7901 CAMERON RD STE 302",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "AUSTIN",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "78754-3831",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "512-775-6392",
"PracticeLocationAddressFaxNumber": "512-990-8387",
"EnumerationDate": "04/19/2018",
"LastUpdateDate": "04/19/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "TUBONEMI",
"AuthorizedOfficialFirstName": "FLORENCE",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "ADMINISTRATOR/OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "512-870-7395",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "010400",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}