{
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"FirstLineMailingAddress": "5533 SOUTHWYCK BLVD STE 101",
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"MailingAddressStateName": "OH",
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"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "419-671-1617",
"MailingAddressFaxNumber": "419-671-1618",
"FirstLinePracticeLocationAddress": "1712 MACOMBER ST",
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"PracticeLocationAddressCityName": "TOLEDO",
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"PracticeLocationAddressTelephoneNumber": "725-289-5475",
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"EnumerationDate": "03/02/2026",
"LastUpdateDate": "03/02/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "DAVISON",
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"AuthorizedOfficialTelephoneNumber": "725-289-5475",
"Taxonomies": {
"Taxonomy": {
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"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}