{
"Npi": {
"NPI": "1437545068",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "Y",
"ParentOrgLBN": "GOOD HYDRATION",
"ParentOrgTIN": null,
"OrgName": "ASSISTED DAILY LIVING IN-HOME HEALTH SERVICES 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": "1360 S 5TH ST",
"SecondLineMailingAddress": "SUITE 356",
"MailingAddressCityName": "SAINT CHARLES",
"MailingAddressStateName": "MO",
"MailingAddressPostalCode": "63301-2449",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "844-273-2700",
"MailingAddressFaxNumber": "636-724-4304",
"FirstLinePracticeLocationAddress": "1360 S 5TH ST",
"SecondLinePracticeLocationAddress": "SUITE 356",
"PracticeLocationAddressCityName": "SAINT CHARLES",
"PracticeLocationAddressStateName": "MO",
"PracticeLocationAddressPostalCode": "63301-2449",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "844-273-2700",
"PracticeLocationAddressFaxNumber": "636-724-4304",
"EnumerationDate": "04/10/2015",
"LastUpdateDate": "07/07/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "MOORE",
"AuthorizedOfficialFirstName": "SHIRLEY",
"AuthorizedOfficialMiddleName": "ANN",
"AuthorizedOfficialTitle": "DIRECTOR",
"AuthorizedOfficialNamePrefix": "MRS.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "844-273-2700",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "291U00000X",
"TaxonomyName": "Clinical Medical Laboratory",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "385H00000X",
"TaxonomyName": "Respite Care",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}