{
"Npi": {
"NPI": "1376787051",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "GRACE IN-HOME CARE LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "22 LEE ST",
"SecondLineMailingAddress": "SUITE 100",
"MailingAddressCityName": "BRISTOL",
"MailingAddressStateName": "VA",
"MailingAddressPostalCode": "24201-4306",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "276-644-9699",
"MailingAddressFaxNumber": "276-644-1487",
"FirstLinePracticeLocationAddress": "22 LEE ST",
"SecondLinePracticeLocationAddress": "SUITE 100",
"PracticeLocationAddressCityName": "BRISTOL",
"PracticeLocationAddressStateName": "VA",
"PracticeLocationAddressPostalCode": "24201-4306",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "276-644-9699",
"PracticeLocationAddressFaxNumber": "276-644-1487",
"EnumerationDate": "04/27/2009",
"LastUpdateDate": "04/27/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MONTGOMERY",
"AuthorizedOfficialFirstName": "DANNY",
"AuthorizedOfficialMiddleName": "EARL",
"AuthorizedOfficialTitle": "PARTNER/MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BS",
"AuthorizedOfficialTelephoneNumber": "423-956-5206",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "HCO-09555",
"LicenseNumberStateCode": "VA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}