{
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"ParentOrgTIN": null,
"OrgName": "ELDER'S JOURNEY HOME CARE OF WABASH VALLEY INC.",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2800 W. US. HWY 40",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BRAZIL",
"MailingAddressStateName": "IN",
"MailingAddressPostalCode": "47834-7206",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "812-442-8899",
"MailingAddressFaxNumber": "812-442-8898",
"FirstLinePracticeLocationAddress": "2800 W. US. HWY 40",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BRAZIL",
"PracticeLocationAddressStateName": "IN",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "812-442-8899",
"PracticeLocationAddressFaxNumber": "812-442-8898",
"EnumerationDate": "07/26/2017",
"LastUpdateDate": "11/13/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HARRISON",
"AuthorizedOfficialFirstName": "ANN",
"AuthorizedOfficialMiddleName": "MARIE",
"AuthorizedOfficialTitle": "OWNER/PRESIDENT",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "RN",
"AuthorizedOfficialTelephoneNumber": "812-442-8899",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": "IN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}