{
"Npi": {
"NPI": "1255310900",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HOME HEALTH INTEGRATED SERVICES, 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": "704 S MAIN ST",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURBANK",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91506-2529",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-558-6685",
"MailingAddressFaxNumber": "818-558-6718",
"FirstLinePracticeLocationAddress": "704 S MAIN ST",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURBANK",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91506-2529",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-558-6685",
"PracticeLocationAddressFaxNumber": "818-558-6718",
"EnumerationDate": "01/11/2006",
"LastUpdateDate": "11/02/2023",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "CAROLINO",
"AuthorizedOfficialFirstName": "AEGEAN",
"AuthorizedOfficialMiddleName": "JAIME",
"AuthorizedOfficialTitle": "PRESIDENT /CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-558-6685",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "980000859",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}