{
"Npi": {
"NPI": "1265695928",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "UNICARE HOME HEALTH SERVICES INCORPORATED",
"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": "6006 159TH ST",
"SecondLineMailingAddress": "BUILDING A, SUITE 2A",
"MailingAddressCityName": "OAK FOREST",
"MailingAddressStateName": "IL",
"MailingAddressPostalCode": "60452-2904",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "708-444-8445",
"MailingAddressFaxNumber": "708-429-2920",
"FirstLinePracticeLocationAddress": "6006 159TH ST",
"SecondLinePracticeLocationAddress": "BUILDING A, SUITE 2A",
"PracticeLocationAddressCityName": "OAK FOREST",
"PracticeLocationAddressStateName": "IL",
"PracticeLocationAddressPostalCode": "60452-2904",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "708-444-8445",
"PracticeLocationAddressFaxNumber": "708-429-2920",
"EnumerationDate": "07/03/2008",
"LastUpdateDate": "01/30/2014",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "REYES",
"AuthorizedOfficialFirstName": "CARMEL",
"AuthorizedOfficialMiddleName": "RUTAQUIO",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "R.N.",
"AuthorizedOfficialTelephoneNumber": "708-444-8445",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "1010836",
"LicenseNumberStateCode": "IL",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}