{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ELDERLESCENT CARE INCORPORATED",
"LastName": null,
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"NamePrefix": null,
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"FirstLineMailingAddress": "6767 FOREST HILL AVE STE 311",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23225-1852",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-255-9993",
"MailingAddressFaxNumber": "804-203-8008",
"FirstLinePracticeLocationAddress": "3520 SKIPPING ROCK WAY",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23234-2971",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-683-9630",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "07/29/2020",
"LastUpdateDate": "07/29/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "JAFARI",
"AuthorizedOfficialFirstName": "LINDA",
"AuthorizedOfficialMiddleName": "MARIA",
"AuthorizedOfficialTitle": "EXECUTIVE DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "MPA, MDIV.",
"AuthorizedOfficialTelephoneNumber": "804-255-9993",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}