{
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"NPI": "1568973741",
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"EIN": null,
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"IsOrgSubpart": "N",
"ParentOrgLBN": null,
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"OrgName": "ALEXA WELLCARE LLC",
"LastName": null,
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"NamePrefix": null,
"NameSuffix": null,
"Credential": null,
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"OtherLastNameTypeCode": null,
"FirstLineMailingAddress": "2029 CENTURY PARK E STE 400",
"SecondLineMailingAddress": null,
"MailingAddressCityName": "LOS ANGELES",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "90067-2905",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "310-990-7249",
"MailingAddressFaxNumber": null,
"FirstLinePracticeLocationAddress": "2029 CENTURY PARK E STE 400",
"SecondLinePracticeLocationAddress": null,
"PracticeLocationAddressCityName": "LOS ANGELES",
"PracticeLocationAddressStateName": "CA",
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"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "310-990-7249",
"PracticeLocationAddressFaxNumber": null,
"EnumerationDate": "10/16/2017",
"LastUpdateDate": "06/11/2019",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "SILVA",
"AuthorizedOfficialFirstName": "LUCAS",
"AuthorizedOfficialMiddleName": "L",
"AuthorizedOfficialTitle": "OPERATION MANAGER",
"AuthorizedOfficialNamePrefix": "MS.",
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"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "310-990-7249",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "253Z00000X",
"TaxonomyName": "In Home Supportive Care Agency",
"LicenseNumber": "8222844269",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}