{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "LILT HOME CARE 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": "8049 STRATFORD CIR S",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SHAKOPEE",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55379-3146",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-484-2752",
"MailingAddressFaxNumber": "952-556-9757",
"FirstLinePracticeLocationAddress": "2400 BLAISDELL AVE STE 100",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "MINNEAPOLIS",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55404-3394",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-484-2752",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "02/26/2021",
"LastUpdateDate": "01/26/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOHAMUD",
"AuthorizedOfficialFirstName": "HAMZA",
"AuthorizedOfficialMiddleName": "MOHAMED",
"AuthorizedOfficialTitle": "OWNER/MANAGER",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "651-208-8925",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}