{
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"IsOrgSubpart": "N",
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"ParentOrgTIN": null,
"OrgName": "CARDINAL HOME HEALTHCARE GROUP, LLC",
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"FirstLineMailingAddress": "35324 EDYTHE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "FARMINGTON HILLS",
"MailingAddressStateName": "MI",
"MailingAddressPostalCode": "48331-2025",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "586-203-8118",
"MailingAddressFaxNumber": "800-558-4559",
"FirstLinePracticeLocationAddress": "3165 OAKMAN BLVD",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "DETROIT",
"PracticeLocationAddressStateName": "MI",
"PracticeLocationAddressPostalCode": "48238-3194",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "586-203-8118",
"PracticeLocationAddressFaxNumber": "800-558-4559",
"EnumerationDate": "04/01/2024",
"LastUpdateDate": "04/01/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CARDENAS",
"AuthorizedOfficialFirstName": "MONSENIOR",
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"AuthorizedOfficialTitle": "MEMBER",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "404-435-9460",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "374U00000X",
"TaxonomyName": "Home Health Aide",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
"HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}