{
"Npi": {
"NPI": "1306878947",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "SUPRA HOME CARE, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 6588",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "METAIRIE",
"MailingAddressStateName": "LA",
"MailingAddressPostalCode": "70009-6588",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "504-837-5557",
"MailingAddressFaxNumber": "504-833-3466",
"FirstLinePracticeLocationAddress": "11333 E PINE ST",
"SecondLinePracticeLocationAddress": "SUITE 10A",
"PracticeLocationAddressCityName": "TULSA",
"PracticeLocationAddressStateName": "OK",
"PracticeLocationAddressPostalCode": "74116-2023",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "918-493-1100",
"PracticeLocationAddressFaxNumber": "918-437-3529",
"EnumerationDate": "07/06/2006",
"LastUpdateDate": "06/08/2011",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BUTLER",
"AuthorizedOfficialFirstName": "LARRY",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT/CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "504-837-5557",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "7147",
"LicenseNumberStateCode": "OK",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}