{
"Npi": {
"NPI": "1316222375",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "RETIRE AT HOME SENIOR CARE LLC",
"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": "501 MOSE DR",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "SPARTA",
"MailingAddressStateName": "TN",
"MailingAddressPostalCode": "38583-1212",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "615-567-5852",
"MailingAddressFaxNumber": "866-704-5370",
"FirstLinePracticeLocationAddress": "501 MOSE DR",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "SPARTA",
"PracticeLocationAddressStateName": "TN",
"PracticeLocationAddressPostalCode": "38583-1212",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "615-567-5852",
"PracticeLocationAddressFaxNumber": "866-704-5370",
"EnumerationDate": "10/20/2011",
"LastUpdateDate": "06/07/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "RAJAB",
"AuthorizedOfficialFirstName": "TAHIR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "256-499-0984",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "L000000009368",
"LicenseNumberStateCode": "TN",
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}