{
"Npi": {
"NPI": "1386840460",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "ENVISION HOME HEALTH SERVICE INC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "17725 CRENSHAW BLVD STE #302",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "TORRANCE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90504",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-515-1246",
"MailingAddressFaxNumber": "310-515-1721",
"FirstLinePracticeLocationAddress": "17725 CRENSHAW BLVD STE #302",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "TORRANCE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "90504",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-515-1246",
"PracticeLocationAddressFaxNumber": "310-515-1721",
"EnumerationDate": "06/25/2007",
"LastUpdateDate": "02/17/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KEGEYAN",
"AuthorizedOfficialFirstName": "KRISTINA",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-522-9252",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "NONE YET",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}