{
"Npi": {
"NPI": "1215164918",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "KIRCHNER SENIOR SERVICES LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2475 S AVE A",
"SecondLineMailingAddress": "STE C",
"MailingAddressCityName": "YUMA",
"MailingAddressStateName": "AZ",
"MailingAddressPostalCode": "85364-7168",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "928-317-3037",
"MailingAddressFaxNumber": "928-317-0667",
"FirstLinePracticeLocationAddress": "2475 S AVE A",
"SecondLinePracticeLocationAddress": "STE C",
"PracticeLocationAddressCityName": "YUMA",
"PracticeLocationAddressStateName": "AZ",
"PracticeLocationAddressPostalCode": "85364-7168",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "928-317-3037",
"PracticeLocationAddressFaxNumber": "928-317-0667",
"EnumerationDate": "06/19/2009",
"LastUpdateDate": "06/19/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KIRCHNER",
"AuthorizedOfficialFirstName": "DAVID",
"AuthorizedOfficialMiddleName": "HAROLD",
"AuthorizedOfficialTitle": "FRANCHISE OWNER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "928-317-3037",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "20366595",
"LicenseNumberStateCode": "AZ",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}