{
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"IsOrgSubpart": "N",
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"OtherCredential": null,
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"FirstLineMailingAddress": "1600 LYNWOOD LN",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ALBANY",
"MailingAddressStateName": "GA",
"MailingAddressPostalCode": "31707-3700",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "229-583-3502",
"MailingAddressFaxNumber": "229-405-3931",
"FirstLinePracticeLocationAddress": "1600 LYNWOOD LN",
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"PracticeLocationAddressCityName": "ALBANY",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "229-583-3502",
"PracticeLocationAddressFaxNumber": "229-405-3931",
"EnumerationDate": "09/25/2026",
"LastUpdateDate": "09/25/2026",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "WESTON",
"AuthorizedOfficialFirstName": "DANA",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": "LICENSE HOME HEALTH",
"AuthorizedOfficialTelephoneNumber": "229-603-8707",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}