{
"Npi": {
"NPI": "1184116469",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "WELL CARE HOME HEALTH CARE 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": "13735 VICTORY BLVD # 303",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "VAN NUYS",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91401-2300",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-285-8908",
"MailingAddressFaxNumber": "818-285-8924",
"FirstLinePracticeLocationAddress": "13735 VICTORY BLVD STE 3",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "VAN NUYS",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91401",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-285-8908",
"PracticeLocationAddressFaxNumber": "818-285-8924",
"EnumerationDate": "06/03/2018",
"LastUpdateDate": "10/24/2018",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KARAKHANYAN",
"AuthorizedOfficialFirstName": "MAYA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-965-9555",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}