{
"Npi": {
"NPI": "1265132633",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "HERITAGE HOME CARE 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": "100 COMMUNITY HEALTH DRIVE",
"SecondLineMailingAddress": "SUITE 101",
"MailingAddressCityName": "EUFAULA",
"MailingAddressStateName": "OK",
"MailingAddressPostalCode": "74432",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "918-707-5049",
"MailingAddressFaxNumber": "539-269-2150",
"FirstLinePracticeLocationAddress": "100 COMMUNITY HEALTH DRIVE",
"SecondLinePracticeLocationAddress": "SUITE 101",
"PracticeLocationAddressCityName": "EUFAULA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74432",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-917-3529",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/06/2023",
"LastUpdateDate": "09/10/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MAHONEY",
"AuthorizedOfficialFirstName": "MELANIE",
"AuthorizedOfficialMiddleName": "D",
"AuthorizedOfficialTitle": "VP",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "918-707-5049",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}