{
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"EIN": null,
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"IsOrgSubpart": "N",
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"NamePrefix": null,
"NameSuffix": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "8401 BOEING DR UNIT 971010",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "EL PASO",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "79997-0003",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "915-317-7000",
"MailingAddressFaxNumber": "915-703-3737",
"FirstLinePracticeLocationAddress": "1717 BROWN ST STE 2B",
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"PracticeLocationAddressCityName": "EL PASO",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "79902-4730",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "915-317-7000",
"PracticeLocationAddressFaxNumber": "915-703-3737",
"EnumerationDate": "06/28/2005",
"LastUpdateDate": "11/01/2021",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SENNESSIE",
"AuthorizedOfficialFirstName": "RICHARD",
"AuthorizedOfficialMiddleName": "SAFFA",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "915-317-7000",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "004455",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}