{
"Npi": {
"NPI": "1316397870",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "JDL HEALTHCARE SERVICES, INC DBA AMADA SENIOR CARE RICHMOND WEST",
"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": "6800 PARAGON PL",
"SecondLineMailingAddress": "SUITE 106",
"MailingAddressCityName": "RICHMOND",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "23230-1649",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "804-793-8255",
"MailingAddressFaxNumber": "804-793-8266",
"FirstLinePracticeLocationAddress": "6800 PARAGON PL",
"SecondLinePracticeLocationAddress": "SUITE 106",
"PracticeLocationAddressCityName": "RICHMOND",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "23230-1649",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "804-793-8255",
"PracticeLocationAddressFaxNumber": "804-793-8266",
"EnumerationDate": "06/15/2016",
"LastUpdateDate": "06/15/2016",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MANN",
"AuthorizedOfficialFirstName": "JAY",
"AuthorizedOfficialMiddleName": "LAWRENCE",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "804-793-8255",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "HCO151287",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}