{
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"IsOrgSubpart": "N",
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"FirstLineMailingAddress": "PO BOX 208",
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"MailingAddressStateName": "WI",
"MailingAddressPostalCode": "53089-0208",
"MailingAddressCountryCode": "US",
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"FirstLinePracticeLocationAddress": "N63W23524 SILVER SPRING DR",
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"PracticeLocationAddressCityName": "SUSSEX",
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"EnumerationDate": "10/01/2019",
"LastUpdateDate": "10/15/2020",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RALIAN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "262-225-7978",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
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"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}