{
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"EIN": null,
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "HIGH COUNTRY HOME CARE, INC",
"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 658",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEWLAND",
"MailingAddressStateName": "NC",
"MailingAddressPostalCode": "28657-0658",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "828-733-1248",
"MailingAddressFaxNumber": "828-733-9064",
"FirstLinePracticeLocationAddress": "496 BALSAM AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPRUCE PINE",
"PracticeLocationAddressStateName": "NC",
"PracticeLocationAddressPostalCode": "28777-2606",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "828-766-9977",
"PracticeLocationAddressFaxNumber": "828-766-7454",
"EnumerationDate": "12/19/2006",
"LastUpdateDate": "07/27/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WARE",
"AuthorizedOfficialFirstName": "GEORGE",
"AuthorizedOfficialMiddleName": "W",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "828-733-1248",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "3747P1801X",
"TaxonomyName": "Personal Care Attendant",
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
}
}
}
}