{
"Npi": {
"NPI": "1396985909",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "A & D HEALTH MANAGEMENT GROUP, INC.",
"ParentOrgTIN": null,
"OrgName": "A & D PROFESSIONAL HOMECARE SERVICES, 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": "205 KELSEY ST",
"SecondLineMailingAddress": "SUITE 104",
"MailingAddressCityName": "NEWINGTON",
"MailingAddressStateName": "CT",
"MailingAddressPostalCode": "06111-5436",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "860-667-2275",
"MailingAddressFaxNumber": "860-667-2276",
"FirstLinePracticeLocationAddress": "205 KELSEY ST",
"SecondLinePracticeLocationAddress": "SUITE 104",
"PracticeLocationAddressCityName": "NEWINGTON",
"PracticeLocationAddressStateName": "CT",
"PracticeLocationAddressPostalCode": "06111-5436",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "860-667-2275",
"PracticeLocationAddressFaxNumber": "860-667-2276",
"EnumerationDate": "02/23/2009",
"LastUpdateDate": "02/23/2009",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "FISHER",
"AuthorizedOfficialFirstName": "DAN",
"AuthorizedOfficialMiddleName": "LESLIE",
"AuthorizedOfficialTitle": "PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": "JR.",
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "860-667-2275",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}