{
"Npi": {
"NPI": "1184886319",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GOOD SAMARITAN HOMECARE AGENCY",
"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": "624 W 85TH ST",
"SecondLineMailingAddress": "SU. 2",
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90044-5860",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "424-222-1115",
"MailingAddressFaxNumber": "323-455-0480",
"FirstLinePracticeLocationAddress": "624 W 85TH ST",
"SecondLinePracticeLocationAddress": "SU. 2",
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90044-5860",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "424-222-1115",
"PracticeLocationAddressFaxNumber": "323-455-0480",
"EnumerationDate": "06/30/2008",
"LastUpdateDate": "06/30/2008",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WASHINGTON",
"AuthorizedOfficialFirstName": "YVETTE",
"AuthorizedOfficialMiddleName": "LASHAUN",
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": "MS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "424-222-1115",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}