{
"Npi": {
"NPI": "1164531901",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "IDEAL HOME CARE, LLC.",
"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": "750 2ND ST NE",
"SecondLineMailingAddress": "SUITE 135",
"MailingAddressCityName": "HOPKINS",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55343-8587",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-392-2314",
"MailingAddressFaxNumber": "952-392-2315",
"FirstLinePracticeLocationAddress": "1050 HIAWATHA AVE",
"SecondLinePracticeLocationAddress": "# 339",
"PracticeLocationAddressCityName": "HOPKINS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55343-8144",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-220-6198",
"PracticeLocationAddressFaxNumber": "952-935-1911",
"EnumerationDate": "08/29/2006",
"LastUpdateDate": "08/22/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ONGERI",
"AuthorizedOfficialFirstName": "LOIS",
"AuthorizedOfficialMiddleName": "BARONGO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "952-220-6198",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "333665",
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}