{
"Npi": {
"NPI": "1215200407",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "VITAL HOME & HEALTHCARE, INC.",
"ParentOrgTIN": null,
"OrgName": "VITAL HOME & HEALTHCARE, 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": "8051 186TH ST",
"SecondLineMailingAddress": "SUITE A",
"MailingAddressCityName": "TINLEY PARK",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60487-9341",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-342-7076",
"MailingAddressFaxNumber": "708-342-7083",
"FirstLinePracticeLocationAddress": "8840 CALUMET AVE",
"SecondLinePracticeLocationAddress": "SUITE 102B",
"PracticeLocationAddressCityName": "MUNSTER",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46321-2545",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "219-513-2055",
"PracticeLocationAddressFaxNumber": "219-513-2056",
"EnumerationDate": "02/17/2012",
"LastUpdateDate": "02/17/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SAYEED",
"AuthorizedOfficialFirstName": "ASIF",
"AuthorizedOfficialMiddleName": "A",
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "708-342-7076",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "12-002870-1",
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}