{
"Npi": {
"NPI": "1427842517",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "PATRICIA HEALTH CARE LLC",
"ParentOrgTIN": null,
"OrgName": "PATRICIA HEALTH CARE LLC",
"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": "5513 BROOKDALE DR N APT 312",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BROOKLYN PARK",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55443-3063",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "929-304-5215",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "5513 BROOKDALE DR N APT 312",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BROOKLYN PARK",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55443-3063",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "929-304-5215",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "04/05/2025",
"LastUpdateDate": "04/05/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "OTIEMORIA",
"AuthorizedOfficialFirstName": "FRANK",
"AuthorizedOfficialMiddleName": "OKHAE",
"AuthorizedOfficialTitle": "MANAGER",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "BSC",
"AuthorizedOfficialTelephoneNumber": "929-304-5215",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}