{
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"FirstLineMailingAddress": "3828 HERON WATCH DR",
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"MailingAddressStateName": "OH",
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"MailingAddressCountryCode": "US",
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"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "3828 HERON WATCH DR",
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"PracticeLocationAddressCityName": "AKRON",
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"PracticeLocationAddressCountryCode": "US",
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"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "11/11/2024",
"LastUpdateDate": "11/11/2024",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KOVACH",
"AuthorizedOfficialFirstName": "JOSEPH",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "HOME ACCESS CONSULTANT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "CHAC",
"AuthorizedOfficialTelephoneNumber": "330-329-1996",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "171WH0202X",
"TaxonomyName": "Home Modifications Contractor",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": {
"HealthcareProviderTaxonomyGroup": {
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"HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
}
}
}
}