{
"Npi": {
"NPI": "1457284192",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "COMFORT NEST ASSISTED LIVING",
"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": "835 ORIOLE AVE",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "GLEN BURNIE",
"MailingAddressStateName": "MD",
"MailingAddressPostalCode": "21060-8437",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "443-989-4554",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "835 ORIOLE AVE",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "GLEN BURNIE",
"PracticeLocationAddressStateName": "MD",
"PracticeLocationAddressPostalCode": "21060-8437",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "443-989-4554",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "06/03/2026",
"LastUpdateDate": "06/03/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BENNARD",
"AuthorizedOfficialFirstName": "GODWIN",
"AuthorizedOfficialMiddleName": "OMOKHEFE",
"AuthorizedOfficialTitle": "OPERATIONS DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "443-989-4554",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "251S00000X",
"TaxonomyName": "Community/Behavioral Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}