{
"Npi": {
"NPI": "1558661710",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "TRI-CARE HOME HEALTH SERVICES, INC.",
"LastName": null,
"FirstName": null,
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
"OtherOrgName": null,
"OtherOrgNameTypeCode": "6",
"OtherLastName": null,
"OtherFirstName": null,
"OtherMiddleName": null,
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": null,
"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "851 BURLWAY RD STE 216",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "BURLINGAME",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "94010-1709",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "650-581-1359",
"MailingAddressFaxNumber": "818-779-1559",
"FirstLinePracticeLocationAddress": "1612 W OLIVE AVE STE 303",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "BURBANK",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91506-2463",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-779-0654",
"PracticeLocationAddressFaxNumber": "818-779-1559",
"EnumerationDate": "10/21/2010",
"LastUpdateDate": "04/15/2025",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BRIONES",
"AuthorizedOfficialFirstName": "YVONNE",
"AuthorizedOfficialMiddleName": "C",
"AuthorizedOfficialTitle": "PROGRAM DIRECTOR",
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "650-581-1359",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "550001582",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}