{
"Npi": {
"NPI": "1487542007",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FREEDOM CARE OF NEW MEXICO LLC",
"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": "1979 MARCUS AVE STE C115",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "NEW HYDE PARK",
"MailingAddressStateName": "NY",
"MailingAddressPostalCode": "11042-1126",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "617-959-4115",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "500 MARQUETTE AVE NW STE 1200",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "ALBUQUERQUE",
"PracticeLocationAddressStateName": "NM",
"PracticeLocationAddressPostalCode": "87102-5312",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "505-391-6400",
"PracticeLocationAddressFaxNumber": "505-460-8655",
"EnumerationDate": "06/24/2025",
"LastUpdateDate": "09/02/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SMITH",
"AuthorizedOfficialFirstName": "KENNETH",
"AuthorizedOfficialMiddleName": "JOHN",
"AuthorizedOfficialTitle": "LEAD, NATIONAL EXPANSION",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "617-959-4115",
"Taxonomies": {
"Taxonomy": [
{
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "N"
},
{
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": null,
"LicenseNumberStateCode": null,
"PrimaryTaxonomySwitch": "Y"
}
]
},
"HealthcareProviderTaxonomyGroups": null
}
}