{
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"LastName": null,
"FirstName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "941 E 86TH ST STE 250",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "INDIANAPOLIS",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "46240-1853",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "317-800-2685",
"MailingAddressFaxNumber": "317-252-2762",
"FirstLinePracticeLocationAddress": "1398 N SHADELAND AVE STE 2203",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "INDIANAPOLIS",
"PracticeLocationAddressStateName": "IN",
"PracticeLocationAddressPostalCode": "46219-3618",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "317-800-6285",
"PracticeLocationAddressFaxNumber": "317-252-2762",
"EnumerationDate": "02/13/2018",
"LastUpdateDate": "10/16/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SINN",
"AuthorizedOfficialFirstName": "DUANE",
"AuthorizedOfficialMiddleName": "L",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "OWNER",
"AuthorizedOfficialTelephoneNumber": "317-800-2685",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
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"LicenseNumberStateCode": "IN",
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}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}