{
"Npi": {
"NPI": "1588863583",
"EntityType": "Organization",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": null,
"IsOrgSubpart": "N",
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": "CRYSTAL CLEAR HOME HEALTH, INC.",
"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": "1016 E BROADWAY",
"SecondLineMailingAddress": "SUITE 109",
"MailingAddressCityName": "GLENDALE",
"MailingAddressStateName": "CA",
"MailingAddressPostalCode": "91205-4532",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "818-241-7141",
"MailingAddressFaxNumber": "818-241-7165",
"FirstLinePracticeLocationAddress": "1016 E BROADWAY",
"SecondLinePracticeLocationAddress": "SUITE 109",
"PracticeLocationAddressCityName": "GLENDALE",
"PracticeLocationAddressStateName": "CA",
"PracticeLocationAddressPostalCode": "91205-4532",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "818-241-7141",
"PracticeLocationAddressFaxNumber": "818-241-7165",
"EnumerationDate": "07/11/2007",
"LastUpdateDate": "10/04/2010",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": null,
"Gender": null,
"AuthorizedOfficialLastName": "BEKARYAN",
"AuthorizedOfficialFirstName": "NAZAR",
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": "CEO PRESIDENT",
"AuthorizedOfficialNamePrefix": "MR.",
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": "818-241-7141",
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "251E00000X",
"TaxonomyName": "Home Health Agency",
"LicenseNumber": "550001047",
"LicenseNumberStateCode": "CA",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}