{
"Npi": {
"NPI": "1205310018",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CITADEL AT HOME 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": "1000 GATES AVE STE 4",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKLYN",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11221-6296",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "917-805-0702",
"MailingAddressFaxNumber": "718-280-1050",
"FirstLinePracticeLocationAddress": "7 GLENWOOD AVE STE 412",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "EAST ORANGE",
"PracticeLocationAddressStateName": "NJ",
"PracticeLocationAddressPostalCode": "07017-1041",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "973-965-0366",
"PracticeLocationAddressFaxNumber": "973-965-0367",
"EnumerationDate": "09/18/2018",
"LastUpdateDate": "03/28/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CRAWFORD",
"AuthorizedOfficialFirstName": "GREGORY",
"AuthorizedOfficialMiddleName": "THOMAS",
"AuthorizedOfficialTitle": "VICE PRESIDENT OF OPERATIONS",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "973-965-0366",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}