{
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"FirstLineMailingAddress": "111 E LUDWIG RD STE 105",
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"MailingAddressCityName": "FORT WAYNE",
"MailingAddressStateName": "IN",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "260-482-9405",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "111 E LUDWIG RD STE 105",
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"PracticeLocationAddressCityName": "FORT WAYNE",
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"PracticeLocationAddressTelephoneNumber": "260-482-9405",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "03/28/2007",
"LastUpdateDate": "09/09/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "ALESSANDRO",
"AuthorizedOfficialFirstName": "STEVEN",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "847-457-1808",
"Taxonomies": {
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"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}