{
"Npi": {
"NPI": "1497127666",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "FACE 2 FACE HOME HEALTH CARE 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": "5747 W BROADWAY AVE STE 102",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "CRYSTAL",
"MailingAddressStateName": "MN",
"MailingAddressPostalCode": "55428-3549",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "952-583-9793",
"MailingAddressFaxNumber": "763-592-8295",
"FirstLinePracticeLocationAddress": "5747 W BROADWAY AVE STE 102",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "CRYSTAL",
"PracticeLocationAddressStateName": "MN",
"PracticeLocationAddressPostalCode": "55428-3549",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "952-583-9793",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/27/2015",
"LastUpdateDate": "07/21/2022",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "HUSSEIN",
"AuthorizedOfficialFirstName": "MUBIN",
"AuthorizedOfficialMiddleName": "MOHAMMED",
"AuthorizedOfficialTitle": "MANGER/CEO",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "952-583-9793",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "302R00000X",
"TaxonomyName": "Health Maintenance Organization",
"LicenseNumber": null,
"LicenseNumberStateCode": "MN",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}