{
"Npi": {
"NPI": "1215736723",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "EL HADDIS HOME HEALTHCARE AGENCY,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": "771 BOSTON POST RD",
"SecondLineMailingAddress": "STE 11 # 1065",
"MailingAddressCityName": "MARLBOROUGH",
"MailingAddressStateName": "MA",
"MailingAddressPostalCode": "01752",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-906-8834",
"MailingAddressFaxNumber": "888-649-5028",
"FirstLinePracticeLocationAddress": "769 CENTER STREET",
"SecondLinePracticeLocationAddress": "JAMAICA PLAIN",
"PracticeLocationAddressCityName": "BOSTON",
"PracticeLocationAddressStateName": "MA",
"PracticeLocationAddressPostalCode": "02130",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "617-906-3488",
"PracticeLocationAddressFaxNumber": "888-649-5028",
"EnumerationDate": "03/10/2025",
"LastUpdateDate": "03/10/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "LABASTILLE",
"AuthorizedOfficialFirstName": "EDWIGE",
"AuthorizedOfficialMiddleName": "S",
"AuthorizedOfficialTitle": "OWNER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "857-544-6636",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}