{
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "DESTINY CARE SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
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"OtherNamePrefix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "7083 WEURFUL DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CANAL WINCHESTER",
"MailingAddressStateName": "OH",
"MailingAddressPostalCode": "43110-8436",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "614-271-2490",
"MailingAddressFaxNumber": "614-321-6080",
"FirstLinePracticeLocationAddress": "7083 WEURFUL DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CANAL WINCHESTER",
"PracticeLocationAddressStateName": "OH",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "614-271-2490",
"PracticeLocationAddressFaxNumber": "614-321-6080",
"EnumerationDate": "09/21/2012",
"LastUpdateDate": "09/21/2012",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MVOA OLAMA",
"AuthorizedOfficialFirstName": "BLAISE",
"AuthorizedOfficialMiddleName": "RAYMOND",
"AuthorizedOfficialTitle": "CHIEF EXECUTIVE OFFICER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "M.B.A",
"AuthorizedOfficialTelephoneNumber": "614-271-2490",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251J00000X",
"TaxonomyName": "Nursing Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}