{
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"NPI": "1487215836",
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"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "AL-SHIFA HOME HEALTH CARE AGENCY LLC",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastName": null,
"OtherFirstName": null,
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"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "PO BOX 5096",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "ANAHEIM",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "92814-1096",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "714-867-1912",
"MailingAddressFaxNumber": "855-624-9362",
"FirstLinePracticeLocationAddress": "6201 BONHOMME RD STE 185N-E",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "HOUSTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77036-4365",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "714-867-1912",
"PracticeLocationAddressFaxNumber": "855-624-9362",
"EnumerationDate": "06/26/2019",
"LastUpdateDate": "06/26/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "KHAN",
"AuthorizedOfficialFirstName": "ZULFIQAR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO",
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"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "714-687-1912",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}